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Detrusor bladder neck dyssynergia revisited
B Schurch1, K Yasuda, A B Rossier
1Swiss Paraplegic Centre, Clinic Balgrist, Zurich University.
The Journal of Urology
|December 1, 1994
Summary
This study demonstrates active bladder neck dyssynergia in spinal cord injury patients. This condition, causing bladder outflow obstruction, appears linked to specific alpha-adrenoreceptors.
Area of Science:
- Urology
- Neuroscience
- Physiology
Background:
- Bladder neck dyssynergia and outflow obstruction are common in neurogenic bladder.
- Direct measurement of active bladder neck closure during contraction has been lacking.
Purpose of the Study:
- To directly measure active bladder neck closure during bladder contraction.
- To investigate the mechanisms of bladder neck dyssynergia in spinal cord injury (SCI) patients.
Main Methods:
- Urodynamic investigation in 34 SCI patients using micro-transducer catheters.
- Evaluation of striated and smooth muscle roles via pudendal nerve blocks and phentolamine injections.
Main Results:
- 25 patients exhibited active bladder neck dyssynergia with detrusor-sphincter dyssynergia.
- Bladder neck pressures exceeded bladder pressures.
- Pudendal blocks affected detrusor-sphincter but not bladder neck dyssynergia.
Conclusions:
- Active bladder neck dyssynergia can occur in neurogenic bladders.
- This dyssynergia appears to involve alpha 1-postsynaptic and alpha 2-presynaptic adrenoreceptors.