Neurogenic bladder

Dysfunction of bladder arising out of neurological disorder is termed as neurogenic bladder.
Neurogenic bladder dysfunction are classified according to functional status of the bladder based on cystometry n urodynamic studies.
Several pattern of of bladder dysfunction r according to detrusor action(Atonic or hypertonic) n spincteric activity(co ordinated or not with detrusor contraction)
lesion affecting sacral segment or peripheral autonomic fibre result in atonic bladder with loss of spincteric co ordination.
This result in loss of detrusor contraction,difficulty in micturation n overflow incontinence.Residual urine volume is increased.

Spinal cord disorder above lumbar segments result in hypertonic bladder with loss of spincteric coordination.Symptoms includes urgency,urge incontinence,incomplete voiding n increased residual urine.
Lesion of cerebral hemishere if located post centrally,result in loss awareness of bladder fullness n cause incontinence,wherease precentral lesion cause difficulty in initiating micturation
neurogenic bladder predisposes to development of urinary infection,back pressure changes at upper urinary tract n requires to b treated appropriately.
Treatment requires correct assesment by urodynamic study followed by proper cathetarisation techniqes,use of pharmacological agent_anticholinergic drug like oxybutylin for detrosor spasticity,alpha blocker like terazosin,if internal spincter fails to relax .
Surgery in certain case.

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