Detrusor Sphincter Dyssynergia

  • Peter K. Sand
  • Donald R. Ostergard


Detrusor sphincter dyssynergia is defined as the lack of external sphincter relaxation during voluntary voiding. This should not be confused with the term “detrusor dyssynergia” which has been applied to the unstable bladder. Detrusor sphincter dyssynergia frequently results in an incomplete voiding effort with elevated residual urine volumes. This condition commonly accompanies detrusor hyperreflexia and may occur in some patients without neurologic disease as a habituation to using a “guarding” reflex to prevent urinary leakage with detrusor instability. The first defense against urine loss is the voluntary contraction of the external striated sphincter of the urethra when an unstable bladder contraction occurs. The end result is evidenced by the trabeculation found in the bladder on cystoscopic examination, the increased EMG activity of the pelvic floor during attempted voiding, and the seemingly paradoxial increased residual urine columes resulting from this involuntary obstruction to urine flow.


Pelvic Floor Vesicoureteral Reflux Detrusor Contraction Detrusor Instability Cystoscopic Examination 
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  1. Allen TD: The non-neurogenic neurogenic bladder. J Urol 117: 232, 1977.PubMedGoogle Scholar
  2. Allen TD, Bright TC: Urodynamic patterns in children with dysfunctional voiding problems. J Urol 119: 247, 1978.PubMedGoogle Scholar
  3. Koff SA: Bladder-sphincter dysfunction in childhood. Urology 19: 457, 1982.PubMedCrossRefGoogle Scholar
  4. Koff SA, Murtagh DS: The uninhibited bladder in children: effect of treatment on recurrence of urinary infection and on vesicoureteral reflux resolution. J Urol 130: 1138, 1983.PubMedGoogle Scholar
  5. Norgaard JP, Djurhuus JC: Treatment of detrusor sphincter dyssynergia by biofeedback. Urol Int 37: 236, 1982.PubMedCrossRefGoogle Scholar
  6. Rudy DS, Awad SA, Downie JW: External sphincter dyssynergia: an abnormal continence reflex. J Urol 140: 105, 1988.PubMedGoogle Scholar
  7. Siroky MB, Krane RJ: Neurologic aspects of detrusor-sphincter dyssynergia with reference to the guarding reflex. J Urol 127: 953, 1982.PubMedGoogle Scholar
  8. Smey P, King LR, Firlit CF: Dysfunctional voiding in children secondary to internal sphincter dyssynergia: treatment with phenoxybenzamine. Urol Clin North Am 7: 337, 1980.PubMedGoogle Scholar
  9. Vereecken RL, Poppel HV, Boeckx G et al: Long term alpha-adrenergic-blocking therapy in detrusor-urethra dyssynergia. Eur Urol 9: 167, 1983.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1995

Authors and Affiliations

  • Peter K. Sand
    • 1
  • Donald R. Ostergard
    • 2
  1. 1.Northwestern University Medical SchoolEvanstonUSA
  2. 2.University of California at IrvineLong BeachUSA

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