Bladder Sphincter Dyssynergia

A physiologically compliant detrusor muscle and a competent urethral sphincter are both necessary to maintain urinary function and continence. Normal micturition has a storage phase and a voiding phase. The storage phase consists of a passive filling of the bladder while voiding needs careful coordination between the detrusor contraction and relaxation of both external and internal sphincters. This complex micturition process is under the control of the central nervous system, which coordinates the activity of the autonomic and somatic nervous systems to guarantee normal urinary continence and micturition. Detrusor sphincter dyssynergia (DSD) is the urodynamic term for variable lower urinary tract symptoms due to detrusor muscle contraction with concomitant and inappropriate involuntary urethral sphincter contraction.