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Pathologies Responsible for the Development of the Neurogenic Bladder

  • Jacques Corcos
  • Mikolaj Przydacz
Chapter

Abstract

  • A wide variety of neurological conditions, lesions, diseases, or injuries of central and/or peripheral nervous system may affect bladder/sphincter innervation and result in clinical presentation of neurogenic bladder (NB). In presenting pathological entities that may lead to NB, special attention should be given for traumatic causes as patients after injuries of head and/or spinal cord represent different diagnostic and therapeutic group with specific symptom evolution.

  • Patients with suprapontine lesions usually present with neurogenic detrusor overactivity with the predominance of storage symptoms. Head injury, stroke, Parkinson’s disease, multiple system atrophy, dementia, brain tumors, and cerebral palsy are the leading disorders in this group.

  • Infrapontine-suprasacral lesions may result in neurogenic detrusor overactivity and/or detrusor-sphincter dyssynergia, thus either storage and/or voiding symptoms might be reported. These findings are distinctive for suprasacral spinal cord injury, multiple sclerosis, transvers myelitis, and spina bifida.

  • In sacral-infrasacral lesions, neurogenic detrusor underactivity is the most frequent finding. Patients are more inclined to report voiding symptoms than storage problems. This presentation typically characterizes sacral spinal cord injury and peripheral neuropathies.

  • Although the pattern of lower urinary tract dysfunction following neurological disease can often be predicted by the location, nature, and extent of the lesion, clinical presentation may significantly vary, thus requiring different therapeutic methods. Clinicians should be aware of these disparities to appropriately treat NB patients.

Keywords

Suprapontine Infrapontine-suprasacral Sacral-infrasacral Head injury Spinal cord injury Stroke Parkinson’s disease Multiple system atrophy Dementia Alzheimer disease Brain tumors Cerebral palsy Multiple sclerosis Transverse myelitis Spina bifida Spinal shock Peripheral neuropathies Diabetes Iatrogenic injury Pelvic surgery Radiation therapy Abdominoperineal resection Rectal cancer Hysterectomy Prostatectomy 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jacques Corcos
    • 1
  • Mikolaj Przydacz
    • 1
  1. 1.Department of UrologyJewish General Hospital, McGill UniversityMontrealCanada

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