ABSTRACT
This chapter focuses on the pathophysiology and prevalence of detrusor sphincter dyssynergia (DSD). DSD is a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscle. Patients with suprasacral spinal cord lesions (SCL) are at risk for DSD secondary to the loss of coordination from pons that can lead to incomplete bladder emptying, high postvoid residual, and increased bladder pressure with resulting obstruction of kidneys leading to renal failure. DSD has been reported in 70%–100% of patients with suprasacral SCL. DSD has been classified not only as intermittent or continuous but also according to the consistency of sphincter contraction during the detrusor contraction. Blaivas described several types of DSD based on the temporal relationship between urethral and sphincter contractions. DSD is seen in 70%–100% of patients with suprasacral SCLs. DSD is also a common finding in patients with MS (28%–82%).
