Detrusor muscle

The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract. The fibers of the detrusor muscle arise from the posterior surface of the body of the pubis in both sexes (musculi pubovesicales), and in the male from the adjacent part of the prostate. These fibers pass, in a more or less longitudinal manner, up the inferior surface of the bladder, over its apex, and then descend along its fundus to become attached to the prostate in the male, and to the front of the vagina in the female. At the sides of the bladder the fibers are arranged obliquely and intersect one another. The three layers of muscles are arranged longitudinal-circular-longitudinal from innermost to outermost. During urination, the detrusor muscle is contracted via parasympathetic branches from the pelvic splanchnic nerves to empty the bladder. At other times, the muscle is kept relaxed via sympathetic branches from the inferior hypogastric plexus to allow the bladder to fill. In older adults over 60 years in age, the detrusor muscle may cause issues in voiding the bladder, resulting in uncomfortable urinary retention. The mucosa of the urinary bladder may herniate through the detrusor muscle. This is most often an acquired condition due to high pressure in the urinary bladder, damage, or existing connective tissue disorders.

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Bladder sphincter dyssynergia

Bladder sphincter dyssynergia (also known as detrusor sphincter dyssynergia (DSD) (the ICS standard terminology agreed 1998) and neurogenic detrusor overactivity (NDO)) is a consequence of a neurological pathology such as spinal injury or multiple sclerosis which disrupts central nervous system regulation of the micturition (urination) reflex resulting in dyscoordination of the detrusor muscles of the bladder and the male or female external urethral sphincter muscles.

Urinary retention

Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections. Causes include blockage of the urethra, nerve problems, certain medications, and weak bladder muscles.

Detrusor muscle

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