Sphincter detrusor dyssynergia

Porena, M., Costantini, E., Rociola, W., and Mearini, E. (2000) Biofeedback successfully cures detrusor-sphincter dyssynergia in pediatric patients. / Urol 163 1927-1931. 

Myelomeningocele is the most common cause of the neurogenic bladder in children. Pressure volume characteristics determine the fate of the urinary tract. There are three predictive indicators for upper tract deterioration detrusor sphincter dyssynergia, high bladder-filling pressure, and poor bladder compliance. Expectant treatment can no longer be advocated. 

Fig. 16.1. Male, 15 years old. Lumbosacral myelomeningocele, contractile detrusor, sphincter detrusor dyssynergia VCU. Contrast-filled bulging posterior urethra, minimal leakage around the catheter, massive reflux of contrast into dilated prostatic ducts. Filling defect (arrowhead) indicates prostatic concrement...

Fig. 16.6. Assessment of sphincter detrusor dyssynergia by modified VCU (Pdet detrusor pressure)...

Fig. 16.7a,b. Male, 4 years old. Lumbar myelomeningocele, contractile detrusor VCU. a Closed bladder neck during bladder filling, bladder trabeculation, and sacculation, b Uninhibited detrusor contractions, massive back-up flow of contrast infusion contrast filled bulging bladder neck (arrow) up to contracted external sphincter (sphincter detrusor dyssynergia), some leakage around the catheter... 

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