Title: What is Neurogenic Bladder?<br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Neurogenic bladder refers to urinary tract dysfunction associated with neurological conditions.</span></span></span></span></li>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">There are 3 patterns that can occur depending on the location of the neurological injury (see figure below):</span></span>    <ul>     <li>      <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Suprapontine lesions (e.g. Parkinson disease) cause involuntary bladder contractions, resulting in <i>urinary incontinence</i>.</span></span></li>     <li>      <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infrapontine to suprasacral lesions (e.g. cervical and thoracic spinal cord injuries) cause uncoordinated bladder and urethral sphincter contractions, resulting in incomplete emptying of the bladder and <i>urinary retention</i>.</span></span></span></span></li>     <li>      <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Sacral/infrasacral lesions (e.g. cauda equina syndrome) cause poor bladder contraction and/or nonrelaxing urethral sphincter, resulting in <i>urinary retention</i>.</span></span></span></span></span></span></li>    </ul>   </li>  </ul>  <p style="margin-left: 80px;">   <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><img alt="" src="http://umem.org/files/uploads/content/pearls/neuro/20200212_Figure.jpg" style="width: 500px; height: 467px;" /></span></span></span></span></span></span></p>  <ul>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Medications such as opiates, anticholinergics, and alpha-adrenoceptor agonists can also cause urinary retention.</span></span></li>  </ul>  <p>   <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong><u>Bottom Line</u>:</strong> Urinary retention can be seen with neurological injury involving the lower brainstem, spinal cord, cauda equina, and peripheral nerves.</span></span></p>  
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                <p>   <span style="font-family: arial, helvetica, sans-serif; font-size: 14px; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);">Panicker JN, Sakakibara R. Lower urinary tract and bowel dysfunction in neurologic disease. </span><i style="font-size: 14px; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); font-family: -webkit-standard;">Continuum (Minneap Minn)</i><span style="font-family: arial, helvetica, sans-serif; font-size: 14px; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);">. 2020;26(1):178-199.</span></p>  <p style="text-align: center;">   <em><strong><span style="font-family: arial, helvetica, sans-serif; font-size: 14px; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);">Follow me on Twitter @EM_NCC</span></strong></em></p>  </fieldset>