Bladder Sphincter Dyssynergia
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Bladder Sphincter Dyssynergia
Bladder sphincter dyssynergia (also known as detrusor sphincter dyssynergia (DSD) (the ICS standard terminology agreed 1998) and neurogenic detrusor overactivity (NDO)) is a consequence of a neurological pathology such as spinal injury or multiple sclerosis which disrupts central nervous system regulation of the micturition (urination) reflex resulting in dyscoordination of the detrusor muscles of the bladder and the male or female external urethral sphincter muscles. In normal lower urinary tract function, these two separate muscle structures act in synergistic coordination. But in this neurogenic disorder, the urethral sphincter muscle, instead of relaxing completely during voiding, dyssynergically contracts causing the flow to be interrupted and the bladder pressure to rise. Presentation People with this condition generally experience daytime and night time wetting, urinary retention, and often have a history of urinary tract and bladder infections. Constipation and encop ...
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Urodynamic
Urodynamic testing or urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests can help explain symptoms such as: * incontinence * frequent urination * sudden, strong urges to urinate but nothing comes out * problems starting a urine stream * painful urination * problems emptying the bladder completely ( Vesical tenesmus, detrusor failure) * recurrent urinary tract infections Urodynamic tests are usually performed in Urology, Gynecology, OB/GYN, Internal medicine, and Primary care offices. Urodynamics will provide the physician with the information necessary to diagnose the cause and nature of a patient's incontinence, thus giving the best treatment options available. Urodynamics is typically conducted by urologists or urogynecologists. Purpose of testing The tests are most often arranged for men with enlarged prostate glands, and for women with incontinence that has either failed conservativ ...
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Spinal Injury
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. Injury can occur at any level of the spinal cord and can be ''complete'', with a total loss of sensation and muscle function at lower sacral segments, or ''incomplete'', meaning some nervous signals are able to travel past the injured area of the cord up to the Sacral S4-5 spinal cord segments. Depending on the location and severity of damage, the symptoms vary, from numbness to paralysis, including bowel or bladder incontinence. Long term outcomes also range widely, from full recovery to permanent tetraplegia (also called quadriplegia) or paraplegia. Complications can include muscle atrophy, loss of voluntary motor control, spasticity, pressure sores, infections, and breathing problems. In the majority o ...
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Multiple Sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Specific symptoms can include double vision, blindness in one eye, muscle weakness, and trouble with sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances. While the cause is unclear, the underlying mechanism is thought to be either destruction by the immune sys ...
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Pontine Micturition Center
The Pontine micturition center (PMC, also known as Barrington's nucleus) is a collection of neuronal cell bodies located in the rostral pons in the brainstem involved in the supraspinal regulation of micturition. When activated, the PMC relaxes the urethral sphincter allowing for micturition to occur. The PMC coordinates with other brain centers, including the medial frontal cortex, insular cortex, hypothalamus and periaqueductal gray (PAG). The PAG acts as a relay station for ascending bladder information from the spinal cord and incoming signals from higher brain areas. Regulation In humans and other mammals, neurons in the PMC send descending excitatory projections to spinally located parasympathetic neurons controlling the detrusor muscle of the bladder and inhibitory interneurons regulating Onuf's nucleus. Additionally, the PMC receives ascending input from the level of the lumbosacral spinal cord. During bladder filling, neurons within the PMC are turned off. However, at ...
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Micturition
Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, and pissing. In healthy humans (and many other animals), the process of urination is under voluntary control. In infants, some elderly individuals, and those with neurological injury, urination may occur as a reflex. It is normal for adult humans to urinate up to seven times during the day. In some animals, in addition to expelling waste material, urination can mark territory or express submissiveness. Physiologically, urination involves coordination between the central, autonomic, and somatic nervous systems. Brain centres that regulate urination include the pontine micturition center, periaqueductal gray, and the cerebral cortex. In placental mam ...
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Detrusor Urinae Muscle
The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract. Structure The fibers of the detrusor muscle arise from the posterior surface of the body of the pubis in both sexes (musculi pubovesicales), and in the male from the adjacent part of the prostate. These fibers pass, in a more or less longitudinal manner, up the inferior surface of the bladder, over its apex, and then descend along its fundus to become attached to the prostate in the male, and to the front of the vagina in the female. At the sides of the bladder the fibers are arranged obliquely and intersect one another. The 3 layers of muscles are arranged ...
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External Sphincter Muscle Of Male Urethra
The external sphincter muscle of male urethra, also sphincter urethrae membranaceae, sphincter urethrae externus, surrounds the whole length of the membranous urethra, and is enclosed in the fascia of the urogenital diaphragm. Its external fibers arise from the junction of the inferior pubic ramus and ischium to the extent of 1.25 to 2 cm., and from the neighboring fascia. They arch across the front of the urethra and bulbourethral glands, pass around the urethra, and behind it unite with the muscle of the opposite side, by means of a tendinous raphe. Its innermost fibers form a continuous circular investment for the membranous urethra. Function The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system. The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves ...
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External Sphincter Muscle Of Female Urethra
The external sphincter muscle of female urethra is a muscle which controls urination in females. The muscle fibers arise on either side from the margin of the inferior ramus of the pubis. They are directed across the pubic arch in front of the urethra, and pass around it to blend with the muscular fibers of the opposite side, between the urethra and vagina. The term "urethrovaginal sphincter" ("sphincter urethrovaginalis") is sometimes used to describe the component adjacent to the vagina. TAA09.5.03.006F FMA30439 The "compressor urethrae" is also considered a distinct, adjacent muscle by some sources, TAA09.5.03.005F FMA30438 Function The muscle helps maintain continence of urine along with the internal urethral sphincter which is under control of the autonomic nervous system. The external sphincter muscle prevents urine leakage as the muscle is tonically contracted via somatic fibers that originate in Onuf's nucleus and pass through sacral spinal nerves S2-S4 then the ...
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Urinary Tract
The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's drainage system for the eventual removal of urine. The kidneys have an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each kidney consists of functional units called nephrons. Following filtration of blood and further processing, wastes (in the form of urine) exit the kidney via the ureters, tubes made of smooth muscle fibres that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination ( voiding). The female and male urinary system are very similar, differing only in the length of the urethra. Urine is formed in the kidneys through a ...
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Constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day. Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders. Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease. Medications associated with constipation include opioids, certain antacids, calcium channel bloc ...
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Encopresis
Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts (fecal soiling) in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments. This term is usually applied to children, and where the symptom is present in adults, it is more commonly known as fecal incontinence (including fecal soiling, fecal leakage or fecal seepage). The term is from the grc, ἐγκόπρησις (). Signs and symptoms * (In)voluntary soiling of undergarments. There are two types: with or without constipation. Those with constipation may experience decreased appetite, abdominal pain, have pain on defecation, have fewer bowel movements, and have hard or soft stools.von Gontard A. Encopresis. In Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions 2012. Those without ...
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Pseudodyssynergia
Pseudodyssynergia (or detrusor sphincter pseudodyssynergia) is an urological condition involving contraction of the male or female external sphincter during voiding. Coordination between the sphincter and detrusor is thus lost.{{Cite web , url=http://www.sghurol.demon.co.uk/urod/boo.htm , title=Archived copy , access-date=2009-12-12 , archive-date=2009-11-24 , archive-url=https://web.archive.org/web/20091124065048/http://www.sghurol.demon.co.uk/urod/boo.htm , url-status=dead See also * Prostatitis Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the ... References Urological conditions ...
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