Neurogenic Bladder

Abstract

The term “neurogenic bladder” encompasses a variety of clinical and urodynamic entities. In general, it refers to clinical problems related to bladder dysfunction secondary to underlying neurological conditions. It is important to obtain a thorough clinical history followed by examination including a good neurological assessment. While this may give clues to the underlying problem, correct management will not be achieved without the aid of laboratory testing, imaging, and urodynamic evaluation, the last in many patients playing a key role in their management. While certain conditions may warrant specific treatments, management, in general, becomes easy once patients are classified based on their urodynamic pattern. The key determinant in the management of neuro-urological problems is to ascertain whether the bladder is “safe” or “unsafe,” i.e., its impact on the renal function. Once this has been determined, management of these entities becomes easy. It is worth remembering that the bladder is a dynamic organ and tends to change physiologically and hence functionally over time. In this chapter, key concepts in identification and management of common clinical entities that cause “neurogenic bladder” will be discussed.