wikipedia - bladder sphincter dyssynergia (checked)

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18/04/15 ladder sphincter dyssynergia - Wikipedia, the free encyclopedia

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Bladder sphincter dyssynergia

Urodynamic trace of detrusor sphincter dyssynerg

Classification and external resources

ICD-9 596.55

(http://www.icd9data.com/getICD9Code.as

icd9=596.55)

Bladder sphincter dyssynergiaFrom Wikipedia, the free encyclopedia

Bladder sphincter dyssynergia(also known as detrusor

sphincter dysynergia(DSD) (the ICS standard terminology

agreed 1998) [1]and neurogenic detrusor overactivity

NDO)) is a consequence of a neurological pathology suchas spinal injury [2]or multiple sclerosis [3]that 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

ract 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

o be interrupted and the bladder pressure to rise. [4]On

cystography there is an irregular appearance of the bladder

outline due to muscular contraction against the unrelaxed

bladder sphincter.[5]

Contents

1 Pathology and symptoms

2 Diagnosis

3 Treatment

4 References

5 Externallinks

Pathology and symptoms

The pathophysiology of the condition results from neuronal plasticity associated with bladder afferents and

motor neurons innervating the external urethral sphincter. Symptomatically, people with this condition genera

experience daytime and night time wetting, urinary retention, and often have a history of urinary tract and

bladder infections. Constipation and encopresis are often associated with this condition.

Diagnosis
http://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Encopresishttp://en.wikipedia.org/wiki/Motor_neuronshttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#External_linkshttp://en.wikipedia.org/wiki/External_sphincter_muscle_of_female_urethrahttp://en.wikipedia.org/wiki/External_sphincter_muscle_of_female_urethrahttp://en.wikipedia.org/wiki/Micturitionhttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-2http://en.wikipedia.org/wiki/Encopresishttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Urinary_tracthttp://en.wikipedia.org/wiki/Motor_neuronshttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#External_linkshttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#Referenceshttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#Treatmenthttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#Diagnosishttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#Pathology_and_symptomshttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-5http://en.wikipedia.org/wiki/Cystographyhttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-4http://en.wikipedia.org/wiki/External_sphincter_muscle_of_female_urethrahttp://en.wikipedia.org/wiki/External_sphincter_muscle_of_male_urethrahttp://en.wikipedia.org/wiki/Detrusor_urinae_musclehttp://en.wikipedia.org/wiki/Micturitionhttp://en.wikipedia.org/wiki/Pontine_micturition_centerhttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-3http://en.wikipedia.org/wiki/Multiple_sclerosishttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-2http://en.wikipedia.org/wiki/Spinal_injuryhttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-1http://www.icd9data.com/getICD9Code.ashx?icd9=596.55http://en.wikipedia.org/wiki/List_of_ICD-9_codeshttp://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttp://en.wikipedia.org/wiki/Urodynamichttp://en.wikipedia.org/wiki/File:Bladder_Sphincter_Dyssynergia_Urodynamic_Trace.jpg


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Strictly DSD can only be diagnosed from an EMG trace or x-ray findings, but the urodynamic trace in the im

shows both the pressure and flow phenomena mentioned.[6]

Treatment

Botulinum A toxin is a valuable alternative for patients with spinal cord injury who can not perform self

catheterisation or do not want surgical methods.[7]

References

1. Manfred Stohrer et al. (1999). "The Standardization of Terminology in Neurogenic Lower Urinary Tract Dysfunction

Neurourology and Urodynamics18(2): 139158. doi:10.1002/(SICI)1520-6777(1999)18:23.0.CO

U (https://dx.doi.org/10.1002%2F%28SICI%291520-6777%281999%2918%3A2%3C139%3A%3AAID-

NAU9%3E3.0.CO%3B2-U). PMID 10081953 (https://www.ncbi.nlm.nih.gov/pubmed/10081953).

2. Karsenty G et al. (2005). "Understanding detrusor sphincter dyssynergia--significance of chronology". Urology66(4)

7638. doi:10.1016/j.urology.2005.04.061 (https://dx.doi.org/10.1016%2Fj.urology.2005.04.061). PMID 16230135

(https://www.ncbi.nlm.nih.gov/pubmed/16230135).

3. E Iu Stankovich, V V Borisov, T L Demina (1999). "Tamsulosin in the treatment of detrusor-sphincter dyssynergia of

urinary bladder in patients with multiple sclerosis". Urologiia: 4851. ISSN 1728-2985

(https://www.worldcat.org/issn/1728-2985). Urination disorders occur in 80% patients with multiple sclerosis (MS). M

common of them is detrusor-sphincter dyssynergia (DSD).

4. Corcos, Jacques; Schick, Erik (2004). Textbook of the neurogenic bladder: adults and children. Informa Health Care.

pp. 163168. ISBN 1-84184-206-0.

5. [1] (http://www.sghurol.demon.co.uk/urod/hyperref.htm) Cystometry shows Neurogenic detrusor overactivity is

overactivity in the presence of confirmed neuropathy in this case Multiple Sclerosis, Doug Small, Department of Urol

Southern General Hospital, Glasgow

6. [2] (http://www.sghurol.demon.co.uk/urod/hyperref.htm) Cystometry shows High detrusor pressure and interrupted. C

not diagnose dyssynergia without emg or radiology but this trace is suggestive of dyssynergic voiding; Doug Small,

Department of Urology, Southern General Hospital, Glasgow

7. http://jnnp.bmj.com/content/63/4/474.full

External links

[3] (http://www.springerlink.com/content/l381732rr087247p/) Lester M. Libo (1983). "EMG biofeedba

for functional bladder-sphincter dyssynergia: A case study".Applied Psychophysiology and Biofeedbac

[4] (http://www.sghurol.demon.co.uk/urod/pf.htm) Pressure Flow Study, Department of Urology, South

General Hospital, Glasgow
http://www.sghurol.demon.co.uk/urod/pf.htmhttp://www.springerlink.com/content/l381732rr087247p/http://jnnp.bmj.com/content/63/4/474.fullhttp://www.sghurol.demon.co.uk/urod/hyperref.htmhttp://www.sghurol.demon.co.uk/urod/hyperref.htmhttp://en.wikipedia.org/wiki/Special:BookSources/1-84184-206-0http://en.wikipedia.org/wiki/International_Standard_Book_Numberhttp://www.worldcat.org/issn/1728-2985http://en.wikipedia.org/wiki/International_Standard_Serial_Numberhttp://www.ncbi.nlm.nih.gov/pubmed/16230135http://en.wikipedia.org/wiki/PubMed_Identifierhttp://dx.doi.org/10.1016%2Fj.urology.2005.04.061http://en.wikipedia.org/wiki/Digital_object_identifierhttp://www.ncbi.nlm.nih.gov/pubmed/10081953http://en.wikipedia.org/wiki/PubMed_Identifierhttp://dx.doi.org/10.1002%2F%28SICI%291520-6777%281999%2918%3A2%3C139%3A%3AAID-NAU9%3E3.0.CO%3B2-Uhttp://en.wikipedia.org/wiki/Digital_object_identifierhttp://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-7http://en.wikipedia.org/wiki/Bladder_sphincter_dyssynergia#cite_note-6http://en.wikipedia.org/wiki/X-rayhttp://en.wikipedia.org/wiki/Electromyography


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