Journal of Neurology

, Volume 253, Issue 8, pp 1103-1110

First online:

Acute urinary retention due to benign inflammatory nervous diseases

  • Ryuji SakakibaraAffiliated withDepartment of Neurology, Chiba University Email author 
  • , Tomonori YamanishiAffiliated withDepartment of Urology, Dokkyo Medical College
  • , Tomoyuki UchiyamaAffiliated withDepartment of Neurology, Chiba University
  • , Takamichi HattoriAffiliated withDepartment of Neurology, Chiba University

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Both neurologists and urologists might encounter patients with acute urinary retention due to benign inflammatory nervous diseases. Based on the mechanism of urinary retention, these disorders can be divided into two subgroups: disorders of the peripheral nervous system (e.g., sacral herpes) or the central nervous system (e.g., meningitis-retention syndrome [MRS]). Laboratory abnormalities include increased herpes virus titers in sacral herpes, and increased myelin basic protein in the cerebrospinal fluid (CSF) in some cases with MRS. Urodynamic abnormality in both conditions is detrusor areflexia; the putative mechanism of it is direct involvement of the pelvic nerves in sacral herpes; and acute spinal shock in MRS. There are few cases with CSF abnormality alone. Although these cases have a benign course, management of the acute urinary retention is necessary to avoid bladder injury due to overdistension. Clinical features of sacral herpes or MRS differ markedly from those of the original “Elsberg syndrome” cases.


urinary retention sacral herpes meningitis-retention syndrome detrusor areflexia Elsberg syndrome