A 60 yrs.old female patient, postmenopausal for 14 years, is suffering from obstructive voiding of urine with burning sensation in the perineal region from last 3 years..  USG done in 2008 shows back voiding volume and narrowing of urethra. In sept.2008,, cystoscopy n dilatation of urethra ws done in apollo hospital.

now,,these symptoms again troubling her. She is non-diabetic, non - hypertensive. on examination, cystorectocele is found. urine r/e shows 3-4 pus cells. urine culture shows no growth. USG (TVS) is s/o small atrophic uterus.. 

her USG (KUB) report is awaited..( soon i will add that )

now, my cause of concern is that she  is having no relief in symptoms with chanderprabhavati and chandanasav.. what can be done in this case??

or she needs cystoscopy n dilatation of urethra again ??

waiting for the valuable advise of experts..

THANKS 

as per the history of the patient gvn by u,she has cystocoel nd rectocoel, so, she needs PFR. meanwhile advice perineal floor exercise to the patient along with ur trtment..............

hii kaurdrgurpreet . thanks 4 ur reply,, but let me tell u dear in this case patient's chief complaint is obstruction in voiding urine with severe burning sensation..prolapse is of first degree only!!  my query is  that what should be done for the prompt relief in the symptoms for which she had cystocopy n dilatation of uretra in the past.. ANY CONSERVATIVE TREATMENT FOR THIS???

for conservative line of management:

1.eladi churna 1gm

  shweta parpaati 250mg

  yava kshara 250mg

with pashanbheda kwatha

2.chandanssav 30ml after meals with equal amount of water