Emptying dysfunction often represents a weakened force of contraction results in retention. This phenomenon is usually associated with combined dysfunction, but may be the predominant pathology in emptying dysfunction. This is most likely a classification issue, since DESD has traditionally been associated with combined dysfunction more than emptying dysfunction. Since bladder sensation may be concurrently altered, symptoms may mimic those of storage dysfunction. Hesitancy or sensation of incomplete bladder emptying may also be present.
Combined dysfunction exhibits features of both storage and emptying disorders.
DESD is the classic pathophysiology and requires a multi-pronged approach. The physiological phenomenon, which involves incoordination of the emptying mechanism - the detrusor is contracting at the same time that the external sphincter contracts, presents a significant health threat. The intravesical pressure rises due to outlet obstruction coincident with detrusor contraction. The risk is that urine will be forced up the ureters causing upper urinary tract damage. Diagnosis The initial screening for any type of urinary complaint is to rule out UTI by routine and microscopic, and culture and sensitivity testing of the urine.