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Die Detrusor-Sphinkter-Dyssynergie und der nicht-relaxierende Sphinkter externus urethrae

  • W. Thon
  • J. E. Altwein

Zusammenfassung

Die Diagnose Detrusor-Sphinkter-Dyssynergie ist ausschließlich definierten neurologischen Läsionen zwischen sakralem Miktionszentrum und vorderer Brük- kenregion vorbehalten. Sie stellt eine funktionell infravesikale Obstruktion durch Inkoordination des Detrusor vesicae und des Sphinkter externus urethrae während Miktion dar. Andersen et al. [6] beschreiben die DSD als zunehmende klonische Sphinkterkontraktion bei Blasendehnung. Sie verlangen den Nachweis des intakten Reflexbogens durch Bestimmung der Latenzzeit des spinalen Reflexes bei gleichzeitigem Unvermögen der Unterdrückung der Sphinkteraktivität. Yalla et al. [89] legen Wert auf die spontane oder provozierte Detrusorhyperreflexie in Verbindung mit der Detrusor-Sphinkter-Dyssynergie. Perkash [63] hält die Diagnose DSD erst für gerechtfertigt, wenn 3 oder mehr rhythmische Detrusorkon- traktionen in Verbindung mit elektromyographisch nachgewiesener Aktivität vorliegen. Die häufigsten neurogenen Ursachen sind der traumatische Querschnitt, die Myelodysplasie und die multiple Sklerose (Tabelle 1). Die Inzidenz beträgt 2–23% (Tabelle 2) [6, 7, 12, 55, 63, 70, 89].

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Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • W. Thon
    • 1
  • J. E. Altwein
    • 1
  1. 1.Urologische AbteilungBundeswehrkrankenhausUlmGermany

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