Skip to main content
SpringerLink
Log in

Neurogenic Bladder

  • Chapter
  • First Online:
Book cover Urologic Principles and Practice

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

  • 1181 Accesses

Abstract

Any pathology of the nervous system leading to any changes on the complex interplay between the autonomic and somatic innervation of the lower urinary tract leads to a “neuropathic bladder”. Always, one must remember that the urinary sphincters may also be affected by any pathology and, in these cases, it is not just the bladder which is neuropathic. This chapter covers, the functions of the bladder which switches from involuntary urine storage to voluntary emptying. We discuss the interaction of the autonomic and somatic nervous systems in allowing this and how pathology has a role in affecting this relationship. Due to the vast complexity of the nervous control of the lower urinary tract a large number of pathologies may be implicated. Therefore we apply an approach whereby lower urinary tract behaviour can be classified according to the type of injury and level of injury. Lesions can thus be classified as suprapontine, suprasacral with a distal autonomous cord (complete or incomplete), subsacral (complete or incomplete), peripheral neuropathies and polyneuropathies. Each “type” of injury may be managed according to the dysfunction which is best assessed with a video urodynamic study.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Oelrich TM. The urethral sphincter muscle in the male. Am J Anat. 1980;158(2):229–46.

    Article  CAS  PubMed  Google Scholar 

  2. Oelrich TM. The striated urogenital sphincter muscle in the female. Anat Rec. 1983;205(2):223–32.

    Article  CAS  PubMed  Google Scholar 

  3. Gallizia P. The smooth sphincter of the vesical neck, a genital organ. Urol Int. 1972;27(4):341–54.

    Article  CAS  PubMed  Google Scholar 

  4. Janig W, Morrison JF. Functional properties of spinal visceral afferents supplying abdominal and pelvic organs, with special emphasis on visceral nociception. Prog Brain Res. 1986;67:87–114.

    Article  CAS  PubMed  Google Scholar 

  5. Fujihara A, Ukimura O, Iwata T, Miki T. Neuroselective measure of the current perception threshold of A-delta and C-fiber afferents in the lower urinary tract. Int J Urol. 2011;18(5):341–9.

    Article  PubMed  Google Scholar 

  6. Vizzard MA, Erdman SL, de Groat WC. Increased expression of neuronal nitric oxide synthase in bladder afferent pathways following chronic bladder irritation. J Comp Neurol. 1996;370(2):191–202.

    Article  CAS  PubMed  Google Scholar 

  7. Kavia RB, Dasgupta R, Fowler CJ. Functional imaging and the central control of the bladder. J Comp Neurol. 2005;493(1):27–32.

    Article  PubMed  Google Scholar 

  8. Nadelhaft I, Vera PL, Card JP, Miselis RR. Central nervous system neurons labelled following the injection of pseudorabies virus into the rat urinary bladder. Neurosci Lett. 1992;143(1-2):271–4.

    Article  CAS  PubMed  Google Scholar 

  9. Siroky MB, Krane RJ. Neurologic aspects of detrusor-sphincter dyssynergia, with reference to the guarding reflex. J Urol. 1982;127(5):953–7.

    Article  CAS  PubMed  Google Scholar 

  10. Blok BF, Willemsen AT, Holstege G. A PET study on brain control of micturition in humans. Brain. 1997;120(Pt 1):111–21.

    Article  PubMed  Google Scholar 

  11. McGuire EJ, Woodside JR, Borden TA, Weiss RM. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol. 1981;126(2):205–9.

    Article  CAS  PubMed  Google Scholar 

  12. Ersoz M, Erhan B, Akkoc Y, Zinnuroglu M, Yildiz N, Gok H, et al. An evaluation of bladder emptying methods and the effect of demographic and clinical factors on spontaneous voiding frequency in stroke patients. Neurol Sci. 2013;34(5):729–34.

    Article  PubMed  Google Scholar 

  13. Barer DH. Continence after stroke: useful predictor or goal of therapy? Age Ageing. 1989;18(3):183–91.

    Article  CAS  PubMed  Google Scholar 

  14. McKenzie P, Badlani GH. The incidence and etiology of overactive bladder in patients after cerebrovascular accident. Curr Urol Rep. 2012;13(5):402–6.

    Article  PubMed  Google Scholar 

  15. Pizzi A, Falsini C, Martini M, Rossetti MA, Verdesca S, Tosto A. Urinary incontinence after ischemic stroke: clinical and urodynamic studies. Neurourol Urodyn. 2014;33:420–5.

    Article  PubMed  Google Scholar 

  16. Ruffion A, Castro-Diaz D, Patel H, Khalaf K, Onyenwenyi A, Globe D, et al. Systematic review of the epidemiology of urinary incontinence and detrusor overactivity among patients with neurogenic overactive bladder. Neuroepidemiology. 2013;41(3-4):146–55.

    Article  PubMed  Google Scholar 

  17. Ragab MM, Mohammed ES. Idiopathic Parkinson’s disease patients at the urologic clinic. Neurourol Urodyn. 2011;30(7):1258–61.

    PubMed  Google Scholar 

  18. Sakakibara R. Cognitive adverse effects of anticholinergic medication for overactive bladder in PD/DLB. Rinsho Shinkeigaku. 2013;53(11):1389–92.

    Article  PubMed  Google Scholar 

  19. Sakakibara R, Shinotoh H, Uchiyama T, Sakuma M, Kashiwado M, Yoshiyama M, et al. Questionnaire-based assessment of pelvic organ dysfunction in Parkinson's disease. Auton Neurosci. 2001;92(1-2):76–85.

    Article  CAS  PubMed  Google Scholar 

  20. Singer C. Urinary dysfunction in Parkinson’s disease. Clin Neurosci. 1998;5(2):78–86.

    CAS  PubMed  Google Scholar 

  21. Sakakibara R, Hattori T, Uchiyama T, Yamanishi T. Videourodynamic and sphincter motor unit potential analyses in Parkinson’s disease and multiple system atrophy. J Neurol Neurosurg Psychiatry. 2001;71(5):600–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Wenning GK, Geser F, Krismer F, Seppi K, Duerr S, Boesch S, et al. The natural history of multiple system atrophy: a prospective European cohort study. Lancet Neurol. 2013;12(3):264–74.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chandiramani VA, Palace J, Fowler CJ. How to recognize patients with parkinsonism who should not have urological surgery. Br J Urol. 1997;80(1):100–4.

    Article  CAS  PubMed  Google Scholar 

  24. Sakakibara R, Kanda T, Sekido T, Uchiyama T, Awa Y, Ito T, et al. Mechanism of bladder dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn. 2008;27(6):507–10.

    Article  PubMed  Google Scholar 

  25. Wu MN, Guo YC, Lai CL, Shen JT, Liou LM. Poststroke detrusor hyporeflexia in a patient with left medial pontine infarction. Neurologist. 2012;18(2):73–5.

    Article  PubMed  Google Scholar 

  26. Soler D, Borzyskowski M. Lower urinary tract dysfunction in children with central nervous system tumours. Arch Dis Child. 1998;79(4):344–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Madersbacher H, Murtz G, Stohrer M. Neurogenic detrusor overactivity in adults: a review on efficacy, tolerability and safety of oral antimuscarinics. Spinal Cord. 2013;51(6):432–41.

    Article  CAS  PubMed  Google Scholar 

  28. Mangera A, Apostolidis A, Andersson KE, Dasgupta P, Giannantoni A, Roehrborn C, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65:981–90.

    Article  CAS  PubMed  Google Scholar 

  29. Chang SM, Hou CL, Dong DQ, Zhang H. Urologic status of 74 spinal cord injury patients from the 1976 Tangshan earthquake, and managed for over 20 years using the Crede maneuver. Spinal Cord. 2000;38(9):552–4.

    Article  CAS  PubMed  Google Scholar 

  30. Barbalias GA, Klauber GT, Blaivas JG. Critical evaluation of the Crede maneuver: a urodynamic study of 207 patients. J Urol. 1983;130(4):720–3.

    Article  CAS  PubMed  Google Scholar 

  31. Momose H, Kashiwai H, Kawata Y, Hirayama A, Hirata N, Yamada K, et al. Difference between the clinical significance of Crede voiding and Valsalva voiding in the urological management of spina bifida patients. Hinyokika Kiyo. 1997;43(11):771–5.

    CAS  PubMed  Google Scholar 

  32. Wyndaele JJ, Madersbacher H, Kovindha A. Conservative treatment of the neuropathic bladder in spinal cord injured patients. Spinal Cord. 2001;39(6):294–300.

    Article  CAS  PubMed  Google Scholar 

  33. Sakakibara R, Hattori T, Tojo M, Yamanishi T, Yasuda K, Hirayama K. The location of the paths subserving micturition: studies in patients with cervical myelopathy. J Auton Nerv Syst. 1995;55(3):165–8.

    Article  CAS  PubMed  Google Scholar 

  34. Sakakibara R, Hattori T, Uchiyama T, Yamanishi T. Urinary dysfunction in Brown-Sequard syndrome. Neurourol Urodyn. 2001;20(6):661–7.

    Article  CAS  PubMed  Google Scholar 

  35. Catto JW, Natarajan V, Tophill PR. Simultaneous augmentation cystoplasty is associated with earlier rather than increased artificial urinary sphincter infection. J Urol. 2005;173(4):1237–41.

    Article  CAS  PubMed  Google Scholar 

  36. Gupta A, Taly AB. Urodynamic profile of patients with neurogenic bladder following non-traumatic myelopathies. Ann Indian Acad Neurol. 2013;16(1):42–6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Copp AJ, Stanier P, Greene ND. Neural tube defects: recent advances, unsolved questions, and controversies. Lancet Neurol. 2013;12(8):799–810.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Verhoef M, Lurvink M, Barf HA, Post MW, van Asbeck FW, Gooskens RH, et al. High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception. Spinal Cord. 2005;43(6):331–40.

    Article  CAS  PubMed  Google Scholar 

  39. Bauer SB, Hallett M, Khoshbin S, Lebowitz RL, Winston KR, Gibson S, et al. Predictive value of urodynamic evaluation in newborns with myelodysplasia. JAMA. 1984;252(5):650–2.

    Article  CAS  PubMed  Google Scholar 

  40. Mitchell LE, Adzick NS, Melchionne J, Pasquariello PS, Sutton LN, Whitehead AS. Spina bifida. Lancet. 2004;364(9448):1885–95.

    Article  PubMed  Google Scholar 

  41. Sultan AH, Kamm MA, Hudson CN. Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol. 1994;101(1):22–8.

    Article  CAS  PubMed  Google Scholar 

  42. Snooks SJ, Swash M, Mathers SE, Henry MM. Effect of vaginal delivery on the pelvic floor: a 5-year follow-up. Br J Surg. 1990;77(12):1358–60.

    Article  CAS  PubMed  Google Scholar 

  43. Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367(9504):57–67.

    Article  PubMed  Google Scholar 

  44. Ward KL, Hilton P. Tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5-year follow up. BJOG. 2008;115(2):226–33.

    Article  CAS  PubMed  Google Scholar 

  45. Jeon MJ, Jung HJ, Chung SM, Kim SK, Bai SW. Comparison of the treatment outcome of pubovaginal sling, tension-free vaginal tape, and transobturator tape for stress urinary incontinence with intrinsic sphincter deficiency. Am J Obstet Gynecol. 2008;199(1):76–4.

    Article  PubMed  Google Scholar 

  46. Phe V, Roupret M, Mozer P, Chartier-Kastler E. Trends in the landscape of artificial urinary sphincter implantation in men and women in France over the past decade. Eur Urol. 2013;63(2):407–8.

    Article  PubMed  Google Scholar 

  47. Trost L, Elliott DS. Male stress urinary incontinence: a review of surgical treatment options and outcomes. Adv Urol. 2012;2012:287489.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Mundy AR. An anatomical explanation for bladder dysfunction following rectal and uterine surgery. Br J Urol. 1982;54(5):501–4.

    Article  CAS  PubMed  Google Scholar 

  49. Everaert K, De MM, Rimbaut S, Weyers S. Urinary retention after hysterectomy for benign disease: extended diagnostic evaluation and treatment with sacral nerve stimulation. BJU Int. 2003;91(6):497–501.

    Article  CAS  PubMed  Google Scholar 

  50. Gross C, Habli M, Lindsell C, South M. Sacral neuromodulation for nonobstructive urinary retention: a meta-analysis. Female Pelvic Med Reconstr Surg. 2010;16(4):249–53.

    Article  PubMed  Google Scholar 

  51. Geurts JJ, Calabrese M, Fisher E, Rudick RA. Measurement and clinical effect of grey matter pathology in multiple sclerosis. Lancet Neurol. 2012;11(12):1082–92.

    Article  PubMed  Google Scholar 

  52. Vita G, Fazio MC, Milone S, Blandino A, Salvi L, Messina C. Cardiovascular autonomic dysfunction in multiple sclerosis is likely related to brainstem lesions. J Neurol Sci. 1993;120(1):82–6.

    Article  CAS  PubMed  Google Scholar 

  53. de SJ, Stojkovic T, Gauvrit JY, Devos D, Ayachi M, Cassim F, et al. Autonomic dysfunction in multiple sclerosis: cervical spinal cord atrophy correlates. J Neurol. 2001;248(4):297–303.

    Article  Google Scholar 

  54. Haensch CA, Jorg J. Autonomic dysfunction in multiple sclerosis. J Neurol. 2006;253(Suppl 1):I3–9.

    Article  PubMed  Google Scholar 

  55. Nakipoglu GF, Kaya AZ, Orhan G, Tezen O, Tunc H, Ozgirgin N, et al. Urinary dysfunction in multiple sclerosis. J Clin Neurosci. 2009;16(10):1321–4.

    Article  CAS  PubMed  Google Scholar 

  56. Ciancio SJ, Mutchnik SE, Rivera VM, Boone TB. Urodynamic pattern changes in multiple sclerosis. Urology. 2001;57(2):239–45.

    Article  CAS  PubMed  Google Scholar 

  57. Cetinel B, Tarcan T, Demirkesen O, Ozyurt C, Sen I, Erdogan S, et al. Management of lower urinary tract dysfunction in multiple sclerosis: a systematic review and Turkish consensus report. Neurourol Urodyn. 2013;32(8):1047–57.

    Article  PubMed  Google Scholar 

  58. Giannantoni A, Scivoletto G, Di Stasi SM, Grasso MG, Vespasiani G, Castellano V. Urological dysfunctions and upper urinary tract involvement in multiple sclerosis patients. Neurourol Urodyn. 1998;17(2):89–98.

    Article  CAS  PubMed  Google Scholar 

  59. Gallien P, Robineau S, Nicolas B, Le Bot MP, Brissot R, Verin M. Vesicourethral dysfunction and urodynamic findings in multiple sclerosis: a study of 149 cases. Arch Phys Med Rehabil. 1998;79(3):255–7.

    Article  CAS  PubMed  Google Scholar 

  60. Panicker JN, Fowler CJ, Kessler TM. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol. 2015;14(7):720–32.

    Article  PubMed  Google Scholar 

  61. Mannen T, Iwata M, Toyokura Y, Nagashima K. The Onuf's nucleus and the external anal sphincter muscles in amyotrophic lateral sclerosis and Shy-Drager syndrome. Acta Neuropathol. 1982;58(4):255–60.

    Article  CAS  PubMed  Google Scholar 

  62. Kihira T, Yoshida S, Yoshimasu F, Wakayama I, Yase Y. Involvement of Onuf’s nucleus in amyotrophic lateral sclerosis. J Neurol Sci. 1997;147(1):81–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK

    Altaf Mangera

Authors
  1. Altaf Mangera
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Sheffield Teaching Hospitals NHS Foundation, Sheffield, UK

    Christopher R. Chapple

  2. Department of Urology, University of Virginia, Charlottesville, VA, USA

    William D. Steers

  3. Department of Urologic Surgery, University of California, Davis, Sacramento, CA, USA

    Christopher P. Evans

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mangera, A. (2020). Neurogenic Bladder. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-28599-9_28

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28598-2

  • Online ISBN: 978-3-030-28599-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation