Detrusor-external sphincter dyssynergia
The Journal of Urology
|April 1, 1981
Summary
Detrusor-external sphincter dyssynergia (DESD) is linked to specific neurologic lesions affecting spinal pathways. Diagnosis requires caution, as DESD is primarily associated with suprasacral spinal cord injuries impacting bladder control.
Area of Science:
- Urology
- Neurology
- Neuroscience
Background:
- Detrusor-external sphincter dyssynergia (DESD) involves involuntary external urethral sphincter contractions during bladder voiding.
- Understanding the neurological basis of DESD is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate the specific neurological lesions associated with detrusor-external sphincter dyssynergia.
- To determine the diagnostic criteria for DESD based on urodynamic findings and neurological status.
Main Methods:
- Retrospective review of urodynamic evaluations from 550 consecutive patients.
- Correlation of voiding patterns with neurological lesion location (suprasacral vs. supracervical).
Main Results:
- DESD was exclusively identified in patients with involuntary detrusor contractions due to suprasacral spinal cord lesions.
- Patients with supracervical neurological lesions exhibited synergistic voiding patterns.
- No cases of DESD were observed in patients without clear neurological lesions.
Conclusions:
- DESD is a distinct neurological condition resulting from interrupted spinal pathways between the pontine micturition center and sacral centers.
- The diagnosis of DESD should be made with extreme caution in the absence of a confirmed neurological lesion.
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