Bladder sphincter dyssynergia explained

Bladder sphincter dyssynergia
Synonyms:	Detrusor sphincter dyssynergia

Bladder sphincter dyssynergia (also known as detrusor sphincter dyssynergia (DSD) (the ICS standard terminology agreed 1998)^[1] and neurogenic detrusor overactivity (NDO)) is a consequence of a neurological pathology such as spinal injury^[2] or multiple sclerosis^[3] which disrupts central nervous system regulation of the micturition (urination) reflex resulting in dyscoordination of the detrusor muscles of the bladder and the male or female external urethral sphincter muscles. In normal lower urinary tract function, these two separate muscle structures act in synergistic coordination. But in this neurogenic disorder, the urethral sphincter muscle, instead of relaxing completely during voiding, dyssynergically contracts causing the flow to be interrupted and the bladder pressure to rise.^[4]

Treatment

Botulinum A toxin is a valuable alternative for patients who do not want surgical methods.^[5]

Further reading

• Libo LM, Arnold GE, Woodside JR, Borden TA, Hardy TL . EMG biofeedback for functional bladder-sphincter dyssynergia: a case study . Biofeedback and Self-Regulation . 8 . 2 . 243–53 . June 1983 . 6357288 . 10.1007/BF00998854 . 8791254 .

Notes and References

1. Stöhrer M, Goepel M, Kondo A, Kramer G, Madersbacher H, Millard R, Rossier A, Wyndaele JJ . The standardization of terminology in neurogenic lower urinary tract dysfunction: with suggestions for diagnostic procedures. International Continence Society Standardization Committee . Neurourology and Urodynamics . 18 . 2 . 139–58 . 1999 . 10081953 . 10.1002/(SICI)1520-6777(1999)18:2<139::AID-NAU9>3.0.CO;2-U . 2592963 .
2. Karsenty G, Reitz A, Wefer B, Boy S, Schurch B . Understanding detrusor sphincter dyssynergia--significance of chronology . Urology . 66 . 4 . 763–8 . October 2005 . 16230135 . 10.1016/j.urology.2005.04.061 .
3. Stankovich EI, Borisov VV, Demina TL . [Tamsulosin in the treatment of detrusor-sphincter dyssynergia of the urinary bladder in patients with multiple sclerosis] . Urologiia . 4 . 48–51 . 2004 . 15457955 . Urination disorders occur in 80% patients with multiple sclerosis (MS). The most common of them is detrusor-sphincter dyssynergia (DSD),
4. Book: Corcos . Jacques . Schick . Erik . vanc . Textbook of the neurogenic bladder: adults and children . Informa Health Care . 2004 . 163–168 . 978-1-84184-206-6 .
5. Schurch B, Hodler J, Rodic B . Botulinum A toxin as a treatment of detrusor-sphincter dyssynergia in patients with spinal cord injury: MRI controlled transperineal injections . Journal of Neurology, Neurosurgery, and Psychiatry . 63 . 4 . 474–6 . October 1997 . 9343126 . 10.1136/jnnp.63.4.474 . 2169779 .