Detrusor-sphincter dyssynergy
| Classification according to ICD-10 | |
|---|---|
| N31.8 | Other bladder neuromuscular dysfunction |
| ICD-10 online (WHO version 2019) | |
The detrusor-sphincter dyssynergia (DSD) is a bladder function disorder caused by the disturbed interaction of when urination is characterized involved anatomical structures.
One of hyperreflexia of the detrusor vesicae is here a spastic dysfunction of the pelvic floor muscles and the external bladder sphincter ( sphincter vesicae externus opposite), resulting in an obstruction of the bladder outlet while Miktionsanstrengung leads. The reflex contraction of the detrusor vesicae muscle is triggered by even small amounts of urine, which leads to incontinence with the loss of small amounts of urine. For this reason, there are only insignificant amounts of residual urine.
The increased intravesical pressure during bladder emptying can lead to detrusor damage , vesicoureteral reflux and thus ultimately to kidney damage.
The cause of the development of a DSD is, for example, a traumatic spinal cord injury , but neurological diseases such as multiple sclerosis can also lead to the clinical picture. In any case, there is damage at the spinal level above the sacral bladder center (S2-S4). The innervation of the detrusor vesicae muscle and reflex arch are only preserved if the sacral bladder center is intact.
Video urodynamics and urethral pressure measurement are used as examination techniques to clarify a DSD .
Sources and individual references
- S2k guideline of the German-speaking Medical Society for Paraplegia (DMGP), 2016: Neuro-urological care of paraplegic patients.
- ↑ KF Masuhr, M. Neumann: disorders of the bladder, rectum and genital function. In: Neurology. (= Dual row). 6th edition. Georg Thieme Verlag, Stuttgart 2007, p. 82 ff.
