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KMID : 0378019790220050065
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New Medical Journal
1979 Volume.22 No. 5 p.65 ~ p.69
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Bladder-Urethral Sphincter Dyssynergia
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Abstract
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Inappropriate contraction or failure of relaxation of either the internal or external urethral sphincter or both ´coincident with detrusor contraction results in a micturitional disorder known as detrusor-urethral sphincter dyssynergia.
Bladder-urethral sphincter dyssynergia has been observed in the case of spinal cord injury or multiple sclerosis.But recently it has been noticed in the case of stress incontinence or in idiopathic cause.
Based on our clinical experience and urodynamic observations.- on 42 cases of urinary dysfunction from any cause, the following results were obtained.
1. On cystometrogram, reflex bladder was noticed in 8/42 cases, paralytic in 16/42 cases, motor paralytic in 8/42 cases and normal CMG with or without dyssynergia in 10/42 cases.
2. Reflex bladder was mostly seen in the case of spinal cord injury in males of the ages of 21-60 and bladder-urethral sphincter dyssynergia was found !in 7/8 cases.
3. Paralytic bladder was seen in cases of spinal cord injury or vertebral abscess (10 case s), DM or uremia (3 cases) and idiopathic cause (3 cases). However this pattern had bladder-urethral sphincter dyssynergia only in 3 cases which was evoked due to detrusor muscle paralysis.
4. Motor paralytic bladder on CMG was observed in cases of spinal cord iniury, DM, phosphorus intoxication and 4/8 cases without any known cause.
In this pattern only 3/8 cases had the bladder-urethral sphincter dyssynergia which was due to detrusor muscle paralysis.
5. Normal CMG with urinary dysfunction was seen in 10 cases and its causes were spinal cord injury (4 cases), pelvic surgery (3 cases) and unknown (2 cases).
Bladder-urethral sphincter dyssynergia was encountered more often in this group (4/8 cases).
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