So as some here may know I have had urge incontinence over the last 20 years. This has been complicated by a slowly worsening neurogenic blockage caused by my sphincters clamping shut when I get a bladder spasm/contraction.
Most urologists I've been to over the years didn't even think something was wrong with me, and others had no idea what was going on (commonly calling it oab). Well a couple of years ago I found my now current urologist at the mayo clinic. He was eventually able to give the possible diagnosis of "incompetent bladder". Basically meaning my bladder isn't working in conjunction with my sphincter.
This was the closest anyone had come and sounded about right. The treatment called for an external sphincterotomy (actually have had 5 surgeries now). However, I have still been having problems with sometimes retaining (where I have to strain to overcome the retention), but other times when my bladder will just drain and I get no problems.
The last time I went in for the surgery my urologist said I was completely open at my internal sphincter, aside from one stricture near my prostrate which he had removed. This sounds right, but only cor half of the time. I was feeling a bit frustrated since he didn't try removing my internal sphincter, and sure enough I'm back to having to sometimes strain again.
Well, attempting to research this some more today I stumbled across the website below. They mention something called "detrusor sphincter dysenergy" Holy crap, this DSD fits my symptoms -exactly-!!! They mention common symptoms are urge incontinence, and retention, and a worsening blockage! I even found one other site that mentioned DSD can be very difficult to detect and diagnose, and sometimes can be mistaken for, wait for it, incompetent bladder. Both sites say an internal sphincterotomy or urethral diversion needs to be done in order to treat it. Now all I have to do is see if my urologist agrees. Unfortunately my next appointment with him isn't for another two months.
http://onlinelibrary.wiley.com/doi/10.1 ... 042.x/full