genitourinary disorders
Neurogenic Bladder
Key Points
Damage to the neural pathways that control voiding can render the bladder too flaccid or spastic. Flaccid bladder tends to cause overflow incontinence. Spastic bladder tends to cause frequency, urge incontinence and, particularly with detrusor-sphincter dyssynergia, retention. Measure postvoid residual volume, do renal ultrasonography and serum creatinine measurement, and in many patients, do cystography, cystoscopy, and cystometrography with urodynamic testing. Treatment for flaccid bladder includes increased fluid intake and intermittent self-catheterization. Treatment for spastic bladder may include measures to trigger urination and/or measures used to treat urge incontinence (including drugs). 