UMEM Educational Pearls

Title: What is Neurogenic Bladder?

Category: Neurology

Keywords: spinal cord injury, cauda equina, urinary retention, incontinence (PubMed Search)

Posted: 2/12/2020 by WanTsu Wendy Chang, MD
Click here to contact WanTsu Wendy Chang, MD

Neurogenic bladder refers to urinary tract dysfunction associated with neurological conditions.
There are 3 patterns that can occur depending on the location of the neurological injury (see figure below):
- Suprapontine lesions (e.g. Parkinson disease) cause involuntary bladder contractions, resulting in urinary incontinence.
- 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 urinary retention.
- Sacral/infrasacral lesions (e.g. cauda equina syndrome) cause poor bladder contraction and/or nonrelaxing urethral sphincter, resulting in urinary retention.

Medications such as opiates, anticholinergics, and alpha-adrenoceptor agonists can also cause urinary retention.

Bottom Line: Urinary retention can be seen with neurological injury involving the lower brainstem, spinal cord, cauda equina, and peripheral nerves.

Additional Information

References

Panicker JN, Sakakibara R. Lower urinary tract and bowel dysfunction in neurologic disease. Continuum (Minneap Minn). 2020;26(1):178-199.

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