ABSTRACT
Normal micturition, because of a sacral spinal reflex under cortical influences, is characterized by a detrusor contraction associated with a complete urethral sphincter relaxation. Treatment is usually necessary to avoid these complications and self-intermittent catheterization associated with anticholinergic drugs, alpha-blockers, antispastic agents, transperineal injections of botulinum toxin, intraurethral stent prosthesis, or sphincterotomy, can be proposed. Detrusor–external sphincter dyssynergia is characterized by involuntary contractions of the external urethral sphincter during an involuntary detrusor contraction. The storage and periodic elimination of urine is dependent on the activity of two functional units in the lower urinary tract: a reservoir and an outlet consisting of the bladder neck, the urethra, and the striated urethral sphincter. The cerebrocortical areas concerned with innervation of the periurethral striated sphincter are located on the medial aspect of the sensorimotor cortex. Bladder sphincter dyssynergia may have an indirect effect on spinal reflex pathways and reflex mechanisms.
