Detrusor Sphincter Dyssynergia

Area of Science:

• Urology
• Neuroscience
• Physiology

Background:

• Detrusor sphincter dyssynergia (DSD) is a condition characterized by involuntary contraction of the urethral sphincter during bladder voiding.
• It typically occurs in patients with spinal cord lesions above the sacral level.
• This dyssynergia leads to elevated intravesical voiding pressures and significant post-void residual volumes.

Purpose of the Study:

• To define Detrusor Sphincter Dyssynergia (DSD).
• To explain the pathophysiology and consequences of DSD.
• To review current treatment approaches for DSD.

Main Methods:

• Literature review on DSD pathophysiology and clinical presentation.
• Analysis of complications associated with untreated DSD.
• Evaluation of current therapeutic strategies for symptomatic management.

Main Results:

• DSD is defined by concurrent detrusor contraction and involuntary urethral sphincter contraction.
• High urethral closure pressures during voiding lead to high intravesical pressures and large post-void residuals.
• Untreated DSD can result in significant complications in up to 50% of affected patients.

Conclusions:

• DSD poses a significant risk of complications due to high voiding pressures and incomplete bladder emptying.
• Current treatments primarily focus on managing symptoms rather than addressing the root causes of DSD.
• Regular follow-up and management are crucial for patients with DSD to prevent severe complications.