Bladder sphincter dyssynergia

Bladder sphincter dyssynergia or more technically detrusor sphincter dysynergia (DSD) is a consequence of a neurological condition such as spinal injury or multiple sclerosis (MS) where the contraction of the bladder musculature is not coordinated with the relaxation of the sphincter. Instead of the urethra relaxing completely during voiding it dyssynergically contracts causing the flow to be interrupted and the detrusor pressure to rise. On cystography there is an irregular appearance of the bladder outline due to muscular contraction against the unrelaxed bladder sphincter. People with this condition generally have daytime and night time wetting and often have a history of urinary tract infections. Constipation and encopresis are often associated with this condition.

Strictly DSD can only be diagnosed from an EMG trace or x-ray findings, but the trace in the image shows both the pressure and flow phenomena mentioned.