Functional urinary outlet obstruction causing urosepsis in a male multiple sclerosis patient.
Detrusor-external sphincter dyssynergia (DESD) is a neuropathic disorder of micturition that exists when the simultaneous contractions of the detrusor muscle and external urethral sphincter oppose each other. When the external urethral sphincter contracts during a detrusor contraction, functional urinary outflow obstruction occurs by the increased urethral resistance. This loss of coordination between the bladder and its outlet is associated with a high risk for serious urologic complications, such as vesicoureteral reflux, hydronephrosis, and urosepsis. This report describes a male multiple sclerosis patient with DESD who developed functional outlet obstruction with urosepsis and discusses the diagnosis and treatment of this potentially life-threatening voiding dysfunction.
Franz
D A
DA
Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville.
Towler
M A
MA
Edlich
R F
RF
Steers
W D
WD
D001437:Bacteriuria / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000209:etiology* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology; D014563:Urodynamics