title: Functional urinary outlet obstruction causing urosepsis in a male multiple sclerosis patient.
abstract: 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.
authors.affiliation: Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville.
authors.forename: D A
authors.initials: DA
authors.lastname: Franz
authors.forename: M A
authors.initials: MA
authors.lastname: Towler
authors.forename: R F
authors.initials: RF
authors.lastname: Edlich
authors.forename: W D
authors.initials: WD
authors.lastname: Steers
mesh_terms: 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