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After visits and tests over the years, my urologist diagnosed me with pseudodyssynergia this summer, and I was referred for biofeedback, which I am scheduled to begin in a few weeks.  Meanwhile, I am having trouble falling asleep due to the consequent pelvic floor tension.  This is even with a benzodiazepine, from which I wish to eventually taper off, as it has lost effectiveness over the years.

What treatments are available for pseudodyssynergia, and where would I find the best programs?  Is there anything I can possibly do (such as clean intermittent catheterization before bedtime, or retrying the drink water and pee cycle) to possibly reduce the muscle tension so that I can void and sleep more easily?



Dyssynergia and pseudodyssnergia can be difficult to treat.  Intermittent catheterization may have a role to play especially if the bladder is not emptying well.  Biofeedback is another tool that is helpful.  Diazepam is the traditional initial remedy.Sometimes, hot sitz baths can help relax muscle tissue.  We are beginning to use botox injections in selected patients, but you will need to check with a university urology medical center program to verify the diagnosis and get this type of treatment. In some cases, we use DDAVP or desmopressin to reduce urine production temporarily overnight to help with some of the nighttime symptoms. Good luck.  


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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