Understanding detrusor sphincter dyssynergia-significance of chronology

In most patients with SCI and DSD, the EUS contraction started before the onset of the bladder contraction. Additionally, in all patients with SCI, the EUS contraction started before the critical part of the bladder contraction. A pathophysiologic hypothesis for such chronology is discussed. A potential therapeutic application would be to use urethral sphincter activity to trigger inhibition of bladder contractions (conditional neuromodulation) and treat the neurogenic overactive bladder.