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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]
The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system.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.
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]
The internal urethral sphincter is a urethral sphincter muscle which constricts the internal urethral orifice. It is located at the junction of the urethra with the urinary bladder and is continuous with the detrusor muscle , [ 1 ] [ 2 ] but anatomically and functionally fully independent from it. [ 3 ]
The perineum attaches across the gap between the inferior pubic rami bilaterally and the perineal body. This grouping of muscles constricts to close the urogenital openings. The perineum supports and functions as a sphincter at the opening of the vagina. Other structures exist below the perineum that support the anus. [3] [6]
Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate.
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.
In acute cases of urinary retention where associated symptoms in the lumbar spine are present such as pain, numbness (saddle anesthesia), parasthesias, decreased anal sphincter tone, or altered deep tendon reflexes, an MRI of the lumbar spine should be considered to further assess cauda equina syndrome. [citation needed]