Neurogenic Bladder

Kumud P Mehta
Neurogenic Bladder - Presentation
Detailed history of age of bladder and bowel control, type of voiding problems. Daytime and nighttime enuresis should be noted. Incontinence or enuresis denotes hyperactive bladder contraction or small capacity bladder. Incontinence may occur during daytime,whilst giggling, laughing etc. Urinary retention may be due to increased tone of sphincter with poor relaxation ex. Detrusor - sphincter dyssynergia (DSD). Continuous dribbling is due to continuous relaxation of sphincters, usually caused by spinal cord lesions affecting cauda equina. Daytime incontinence in children above 8 years of age without obvious neurologic cause needs complete work up of neurogenic bladder. Family history of incontinence may be present.

Detailed examination of back to detect nevus, hair, lump, dimple which indicates abnormalities of spine like spina bifida, lipomeningocele, sacral agenesis which can be diagnosed by simple x-ray of spine followed by MRI to detect spinal cord compression and/or tethering requiring surgery. Examination of genitals, neurological examination for paraplegia, hydrocephalus and tone of anal sphincters are important points.

Neurogenic Bladder Neurogenic Bladder 01/03/2001
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