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  1. #1

    Help with Diagnosis

    I am still trying to get my mind set on my bladder diagnosis. My urologist said that I have an atonic (flaccid) bladder with no DSD.

    However, my external urinary sphincter is tight as is my anal sphincter. No leakage whatsoever. I can feel the spasms in my anal sphincter.

    Now doesn't a tight sphincter = a spastic sphincter? Could this cause a misdiagnosis of a flaccid bladder? Is it possible that they told me flaccid bladder when what they should have told me was spastic sphincter? If so, is there any medicine to help with a tight sphincter?

    Am I thinking to much on this?

  2. #2
    Your bladder and external sphincter are separately innervated. The bladder is innervated by parasympathetic nerves that come from S2-4, while the external sphincter is innervated by somatic nerves that come from S2-4. In a mixed bladder picture, it is possible to have a spastic sphincter, but a flaccid bladder. Urodynamics would be needed to determine this. Did you have that done?

    Baclofen and other antispasticity meds often help with a spastic external sphincter, although not always. Are you sure you don't have a stricture instead of spasm? Again, DSD requires urodynamics to diagnose, and you can't have DSD if you don't have bladder contractions, although you could still have a spastic sphincter (as above).

    (KLD)

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