11.4: Classification

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It is clear from the previous physiologic description that a simple classification is not possible. Therefore, the physician should evaluate detrusor and sphincteric function as separate entities. Both of these can be either normal, hyperactive or hypoactive in function. It is also important to make sure that there is co-ordination between the detrusor and sphincteric function. Sphincteric function has an autonomic (sympathetic) and a somatic control. Incoordination is described as detrusor-sphincter dyssynergia. The diagnosis of detrusor-sphincter-dyssynergia will not state which system causes the outflow obstruction (sympathetic or somatic). These can, however, be differentiated by proper examination. A distinction should be made between detrusor-smooth muscle sphincter dyssynergia or detrusor-striated muscle dyssynergia. The higher the lesions, the more hyperactivity we find and the lower the lesion, the more hypofunction.

Figure $$\PageIndex{1}$$: This classification will give a good description of the pathophysiology as well as guide further treatment

The evaluation of the patient should include:

• Detrusor function
• Urethral function
• Co-ordination between the two

This page titled 11.4: Classification is shared under a CC BY-NC-SA 2.5 license and was authored, remixed, and/or curated by Stephen Jeffery and Peter de Jong via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.