title: Management of detrusor-external sphincter dyssynergia.
abstract: Detrusor-external sphincter dyssynergia (DSD) is a debilitating problem in patients with spinal cord injury. DSD carries a high risk of complications, and even life expectancy can be affected. The mainstay of treatment is the use of antimuscarinic medication and catheterization, but in those for whom this is not possible external sphincterotomy has been the traditional management route. External sphincterotomy, however, is associated with significant risks, including hemorrhage, erectile dysfunction and the need for repeat procedures, and over the last decade alternatives have been investigated, such as urethral stents and botulinum toxin injection. We present a review of DSD, including the current management strategies and prospects for future treatment.
authors.affiliation: Institute of Urology and Nephrology, University College London, London, UK.
authors.forename: Hashim U
authors.initials: HU
authors.lastname: Ahmed
authors.forename: Iqbal S
authors.initials: IS
authors.lastname: Shergill
authors.forename: Manit
authors.initials: M
authors.lastname: Arya
authors.forename: P Julian R
authors.initials: PJ
authors.lastname: Shah
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D016587:Antimutagenic Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002404:Catheterization; D006801:Humans; D020030:Nitric Oxide Donors / Q000627:therapeutic use; D013119:Spinal Cord Injuries / Q000150:complications*; D015607:Stents; D014521:Urethra / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014546:Urinary Catheterization
chemical_list: D000317:Adrenergic alpha-Antagonists; D018726:Anti-Dyskinesia Agents; D016587:Antimutagenic Agents; D020030:Nitric Oxide Donors; D001905:Botulinum Toxins