UMEM Educational Pearls

Category: Neurology

Title: What is Neurogenic Bladder?

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

Posted: 2/12/2020 by WanTsu Wendy Chang, MD
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Takeaways

  • 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.

In-Depth

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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