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  • Updated 03.23.2024
  • Released 07.17.2000
  • Expires For CME 03.23.2027

Urinary dysfunction in neurologic disorders



Every neurologic disease affecting the central or peripheral nervous system can disturb the neuronal control of the lower urinary tract, leading to bladder storage and emptying dysfunction. Consequently, patients may report various symptoms (eg, urinary incontinence or retention) that can lead to pathological high intravesical pressure during the storage phase and deterioration of renal function, as well as other complications like infections and stone formation.

Knowledge of the neuropathophysiology of bladder control and its relationship to lower urinary tract dysfunction is key to improving the management of patients with neurogenic lower urinary tract dysfunction. This article includes updated information on the diagnosis and management of lower urinary tract dysfunction in various neurologic diseases.

Key points

• Patients with neurologic disease often develop neurogenic lower urinary tract dysfunction affecting urine storage and emptying.

• Neurogenic lower urinary tract dysfunction may cause both bladder storage and emptying symptoms that potentially damage long-term kidney function.

• Lower urinary tract dysfunction needs treatment when symptoms are bothersome and complications, such as recurrent symptomatic urinary tract infections or bladder stones, occur.

• Neurogenic detrusor overactivity in spinal cord injury may lead to elevated intravesical pressures that deteriorate the upper urinary tract.

• Neurogenic lower urinary tract dysfunction often coexists with non-neurogenic lower urinary tract dysfunction, like overactive bladder, benign prostatic hyperplasia, and stress urinary incontinence.

• Treatment of non-neurogenic lower urinary tract dysfunction may worsen neurogenic lower urinary tract dysfunction.

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