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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 ...
The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine , and contracts during urination to release urine.
Overactive bladder (OAB) is a common condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. [2] The frequent need to urinate may occur during the day, at night, or both. [4]
The physical finding of detrusor activity of insufficient strength or duration to ensure efficient bladder emptying is properly termed "detrusor underactivity" (DU). [1] Historically, UAB and DU (as well as others such as 'bladder underactivity') have been often used interchangeably, [2] leading to both terminologic and pathophysiologic confusion.
The most valuable test to test for detrusor sphincter dyssynergia (DESD) is to perform cystometry simultaneously with external sphincter electromyography (EMG). [8] Uroflowmetry is a less-invasive study that can measure urine flow rate and use it to estimate detrusor strength and sphincter resistance.
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Detrusor muscle weakness and/or instability; Diabetes; Use of ketamine [11] Neurological conditions; for example multiple sclerosis, spinal cord injury, cauda equina syndrome; Prostatitis, including IgG4-related prostatitis [12] [13] [14] Urethral stricture; Urinary tract infections (UTIs) [15]