Incontinence Due to Neurogenic Sphincter Deficiency

  • Jacques Corcos
  • Mikolaj Przydacz


  • Incontinence due to neurogenic sphincter deficiency (NSD) typically occurs in individuals with myelodysplasia, sacral agenesis, sacral/infrasacral spinal cord injury, laminectomy complications, vertebral disk disease, severe pelvic fractures, and nerve injury from resection of low colorectal cancers.

  • A comprehensive history and physical examination should be supported by a bladder diary, symptom questionnaires, urinalysis, urine culture, pad-weighing test, renal assessment, and optional other investigations. Urodynamic testing provides objective data of NSD presented as stress urinary incontinence. Low maximal urethral closure pressure and low abdominal leak point pressure are commonly used as indicators of intrinsic sphincter deficiency.

  • Management includes conservative treatment with pelvic floor rehabilitation, artificial urinary sphincters, slings (autologous and synthetic), peri-urethral bulking agents, adjustable continence devices, bladder neck reconstruction techniques, and supraurethral diversion with bladder neck/urethra closure.


Intrinsic sphincter deficiency Neurogenic sphincter deficiency Myelodysplasia Sacral agenesis Sacral/infrasacral spinal cord injury Laminectomy complications Vertebral disk disease Pelvic fractures Colorectal cancers Artificial urinary sphincter Autologous sling Synthetic sling Mid-urethral slings Peri-urethral bulking agents Bladder neck reconstruction Bladder neck/urethra closure 


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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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