Detruzorno-sfinkternaya dyssynergia
Contents:
Description:
Detruzorno-sfinkternaya a dyssynergia – a state at which simultaneous reduction of a detruzor and cross-striped sphincter of an urethra is noted. Whereas, normal at an urination at the time of relaxation of a cross-striped sphincter the detruzor is reduced. In this clinical situation the weak stream of urine, a discontinuous urination and pain is noted.
Reasons of a detruzorno-sphincteric dyssynergia:
Neurologic changes at the level of conduction paths of a spinal cord, such as osteochondrosis, hemangiomas, hernias, multiple sclerosis, multisystem atrophy, etc. are the reason of it.
Diagnosis:
The diagnostic algorithm of a detruzorno-sphincteric dyssynergia includes: the general analysis of urine, crops of urine on sterility with antibiotikogrammy, filling of the questionnaire of IPSS, ultrasound examination of a bladder with scoping of a residual urine and comprehensive urodynamic examination.
Detruzorno-sfinkternaya dyssynergia
Treatment of a detruzorno-sphincteric dyssynergia:
For treatment a1-adrenoblockers are used. Drugs of this group I block momentum transfer of a sympathetic nervous system on a1 – the receptors located in a bladder neck. As a result smooth muscle muscles relax, the tone of a vascular wall raises and the blood stream in a detruzor is normalized.
The central muscle relaxants are to a lesser extent used. They reduce activity of motor neurons and inhibit transfer of nervous impulse in a spinal cord therefore spasticity of striated muscles decreases. However drugs have no organ specificity, and the main side effect is the expressed weakness of muscles of extremities that considerably limits their use.
One of methods of treatment of a detruzorno-sphincteric dyssynergia is tibialny neuromodulation.
Refer administration of botulinum toxin (drug BOTOX) in a cross-striped sphincter of an urethra to operational methods. The mechanism of action BOTOX consists in blockade of release of a mediator of reduction (acetylcholine). In the investigation of what the impulse causing a spasm is interrupted and does not reach a muscle. The primeniyeniya of BOTOX is result relaxation of muscular structures. At a detruzorno-sphincteric dyssynergia the detruzor while the cross-striped sphincter of an urethra remains weakened is reduced.
