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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 external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves S2-S4 then the pudendal nerve to synapse on the muscle. [7] [10] Voiding urine begins with voluntary relaxation of the external urethral sphincter.
Neurogenic bladder dysfunction can involve a malfunctioning urethral sphincter. [8] Urge incontinence can happen when the urethra cannot hold the urine in as the bladder contracts uncontrollably. [9] Retrograde ejaculation can occur in men when the internal urethral sphincter fails to adequately contract during ejaculation. [3]
Fowler's syndrome (urethral sphincter relaxation disorder) is a rare disorder in which the urethral sphincter fails to relax to allow urine to be passed normally in younger women with abnormal electromyographic activity detected. [1] [2] [3] [4]
Symptoms reported by the patient are an unreliable guide to the underlying dysfunction of the lower urinary tract. [ citation needed ] The purpose of urodynamics is to provide objective confirmation of the pathology that a patient's symptoms would suggest.
Urethral syndrome is defined as symptoms suggestive of a lower urinary tract infection but in the absence of significant bacteriuria with a conventional pathogen. [1] It is a diagnosis of exclusion in patients with dysuria and frequency without demonstrable infection. [2] In women, vaginitis should also be ruled out. [3]
Large studies of patients have also failed to show any correlation between lower urinary tract symptoms and a specific diagnosis. [11] Also, recently a report of lower urinary tract symptoms even with malignant features in the prostate failed to be associated with prostate cancer after further laboratory investigation of the biopsy. [10]
Obstructive uropathy is a structural or functional hindrance of normal urine flow, [1] sometimes leading to renal dysfunction (obstructive nephropathy). It is a very broad term, and does not imply a location or cause.