Detrusor Sphincter Dyssynergia

Abstract

Detrusor sphincter dyssynergia (DSD) is defined as a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscles typically occurring in a patient with a spinal cord lesion above the sacral cord. Consequently, high urethral closure pressures during the detrusor contraction leads to high intravesical voiding pressure and large postvoid residuals, which can lead to significant complications in up to 50% of patients if DSD is not treated and followed-up regularly. DSD treatment options are centered around symptomatic management rather that addressing the underlying causative mechanisms.

Keywords: Botulinum toxin; Catheterization; Pelvic floor electromyography; Pharmacotherapy; Pontine micturition center; Sacral neuromodulation; Spinobulbospinal pathway; Videocystometrography.