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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 ...
Dyssynergia is any disturbance of muscular coordination, resulting in uncoordinated and abrupt movements. This is also an aspect of ataxia. [1] It is typical for dyssynergic patients to split a movement into several smaller movements. Types of dyssynergia include Ramsay Hunt syndrome type 1, bladder sphincter dyssynergia, and anal sphincter ...
Treatment depends on the type of neurogenic bladder and other medical problems. Treatment strategies include catheterization, medications, surgeries or other procedures. The goals of treatment focus on preserving the structure and function of the upper urinary tract, and on improving the quality of life for patients with neurogenic bladder. [2]
Without diagnostic evaluation, the cause of underactive bladder is unclear, as there are multiple possible causes. UAB symptoms can accurately reflect impaired bladder emptying due either to DU or obstruction (normal or large storage volumes, elevated post-void residual volume), or can result from a sense of incomplete emptying of a hypersensitive bladder (small storage volumes, normal or ...
It is also a common treatment used among spinal cord injury patients who are unable or unwilling to use intermittent catheterization to empty the bladder and cannot otherwise void due to detrusor sphincter dyssynergia.
People often have the symptoms for a long time before seeking treatment and the condition is sometimes identified by caregivers. [1] Diagnosis is based on a person's signs and symptoms and requires other problems such as urinary tract infections or neurological conditions to be excluded. [2] [1] Uroflowmetry is also a good diagnostic aid. [8]
The detrusor muscle is the muscular layer of the wall made of smooth muscle fibers arranged in spiral, longitudinal, and circular bundles. [8] The detrusor muscle is able to change its length. It can also contract for a long time whilst voiding , and it stays relaxed whilst the bladder is filling. [ 9 ]
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.