Management of detrusor-external sphincter dyssynergia.
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.
Ahmed
Hashim U
HU
Institute of Urology and Nephrology, University College London, London, UK.
Shergill
Iqbal S
IS
Arya
Manit
M
Shah
P Julian R
PJ
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
D000317:Adrenergic alpha-Antagonists; D018726:Anti-Dyskinesia Agents; D016587:Antimutagenic Agents; D020030:Nitric Oxide Donors; D001905:Botulinum Toxins