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• W2411025099 abstract "No AccessJournal of UrologyUrological Neurology and Urodynamics1 Oct 1978Detrusor-sphincter Dyssynergia and Dyssynergic Responses: Recognition and Rationale for Early Modified Transurethral Sphincterotomy in Complete Spinal Cord Injury Lesions Inder Perkash Inder PerkashInder Perkash More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)57233-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Abstract: Some characteristics are described for detrusor-sphincter dyssynergia and the dyssynergic response in spinal injury patients with complete lesions. The urodynamic evaluation and clinical problems are analyzed in 53 patients to identify the importance of early recognition of sphincter dyssynergia. Cystomanometric and urethral profile pressures vary from 30 to 150cm. water. Although high voiding pressure, particularly associated with autonomic dysreflexia, may be indicative of sphincter dyssynergia it is not diagnostic. Relevant characteristics of patients with detrusor-sphincter dyssynergia are 1) rhythmic detrusor contractions on cystomanometry with associated marked increase in electromyographic activity of the external urethral sphincter or 2) an areflexic bladder with concomitant increase in electromyographic activity on attempted voiding. These characteristics enable early recognition of dyssynergia and afford expediency in its management. The modified approach to external sphincterotomy as practiced by the author provides optimalsurgical approach for urological rehabilitation of dyssynergic patients. Thus, the rationale for characterization of dyssynergia and its management by modified sphincterotomy can help to terminate long-term intermittent catheterization, remove indwelling catheter, prevent renal damage and ameliorate autonomic dysreflexia. © 1978 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByKim Y, Kattan M and Boone T (2018) BLADDER LEAK POINT PRESSURE: THE MEASURE FOR SPHINCTEROTOMY SUCCESS IN SPINAL CORD INJURED PATIENTS WITH EXTERNAL DETRUSOR-SPHINCTER DYSSYNERGIAJournal of Urology, VOL. 159, NO. 2, (493-497), Online publication date: 1-Feb-1998.Perkash I (2018) Editorial: Vesicourethral Dysfunction-Neurogenic and Nonneurogenic ConsiderationsJournal of Urology, VOL. 156, NO. 5, (1751-1752), Online publication date: 1-Nov-1996.Linsenmeyer T, Campagnolo D and Chou I (2018) Silent Autonomic Dysreflexia During Voiding in Men with Spinal Cord InjuriesJournal of Urology, VOL. 155, NO. 2, (519-522), Online publication date: 1-Feb-1996.Light J and Beric A (2018) Detrusor Function In Suprasacral Spinal Cord InjuriesJournal of Urology, VOL. 148, NO. 2 Part 1, (355-358), Online publication date: 1-Aug-1992.Gerridzen R, Thijssen A and Dehoux E (2018) Risk Factors for Upper Tract Deterioration in Chronic Spinal Cord Injury PatientsJournal of Urology, VOL. 147, NO. 2, (416-418), Online publication date: 1-Feb-1992.Trop C and Bennett C (2018) Autonomic Dysreflexia and its Urological Implications: A ReviewJournal of Urology, VOL. 146, NO. 6, (1461-1469), Online publication date: 1-Dec-1991.Barton C, Khonsari F, Vaziri N, Byrne C, Gordon S and Friis R (2018) The Effect of Modified Transurethral Sphincterotomy on Autonomic DysreflexiaJournal of Urology, VOL. 135, NO. 1, (83-85), Online publication date: 1-Jan-1986.Tempkin A, Sullivan G, Paldi J and Perkash I (2018) Radioisotope Renography in Spinal Cord InjuryJournal of Urology, VOL. 133, NO. 2, (228-230), Online publication date: 1-Feb-1985.Koyanagi T, Arikado K, Takamatsu T and Tsuji I (2018) Experience with Electromyography of the External Urethral Sphincter in Spinal Cord Injury PatientsJournal of Urology, VOL. 127, NO. 2, (272-276), Online publication date: 1-Feb-1982.Wein A (2018) Editorial CommentJournal of Urology, VOL. 127, NO. 2, (276-276), Online publication date: 1-Feb-1982.Perkash I (2018) Problems of Decatheterization in Long-term Spinal Cord Injury PatientsJournal of Urology, VOL. 124, NO. 2, (249-253), Online publication date: 1-Aug-1980.A.B.R. (2018) Editorial CommentJournal of Urology, VOL. 124, NO. 2, (253-253), Online publication date: 1-Aug-1980. (2018) Reply by AuthorJournal of Urology, VOL. 124, NO. 2, (253-253), Online publication date: 1-Aug-1980.Mayo M and Kiviat M (2018) Increased Residual Urine in Patients with Bladder Neuropathy Secondary to Suprasacral Spinal Cord LesionsJournal of Urology, VOL. 123, NO. 5, (726-728), Online publication date: 1-May-1980.Rhame F and Perkash I (2018) Urinary Tract Infections Occurring in Recent Spinal Cord Injury Patients on Intermittent CatheterizationJournal of Urology, VOL. 122, NO. 5, (669-673), Online publication date: 1-Nov-1979.Perkash I (2018) Pressor Response During Cystomanometry in Spinal Injury Patients Complicated with Detrusor-Sphincter DyssynergiaJournal of Urology, VOL. 121, NO. 6, (778-782), Online publication date: 1-Jun-1979.Bradley W (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 6, (782-782), Online publication date: 1-Jun-1979.Perkash I (2018) Detrusor-Sphincter Dyssynergia and Detrusor Hyperreflexia Leading to Hydronephrosis During Intermittent CatheterizationJournal of Urology, VOL. 120, NO. 5, (620-622), Online publication date: 1-Nov-1978. Volume 120Issue 4October 1978Page: 469-474 Advertisement Copyright & Permissions© 1978 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Inder Perkash More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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