genitourinary disorders
Neurogenic Bladder
Introduction
Neurogenic bladder is bladder dysfunction (flaccid or spastic) caused by neurologic damage. Symptoms can include overflow incontinence, frequency, urgency, urge incontinence, and retention. Risk of serious complications (eg, recurrent infection, vesicoureteral reflux, autonomic dysreflexia) is high. Diagnosis involves imaging and cystoscopy or urodynamic testing. Treatment involves catheterization or measures to trigger urination. (See also Overview of Voiding .) Any condition that impairs bladder and bladder outlet afferent and efferent signaling can cause neurogenic bladder. Causes may involve the central nervous system (eg, Overview of Stroke , Inflaccid (hypotonic) neurogenic bladder,volume is large, pressure is low, and contractions are absent. It may result from peripheral nerve damage or spinal cord damage at the S2 to S4 level. After acute cord damage, initial flaccidity may be followed by long-term flaccidity or spasticity, or bladder function may improve after days, weeks, or months. Inspastic bladder,volume is typically normal or small, and involuntary contractions occur. It usually results from brain damage or spinal cord damage above T12. Precise symptoms vary by site and severity of the lesion. Bladder contraction and external urinary sphincter relaxation are typically uncoordinated (detrusor-sphincter dyssynergia). (flaccid and spastic bladder) may be caused by many disorders, including Syphilis , 