Rinsho Shinkeigaku (Clinical Neurology)


Neurology and the bladder: how to assess and manage neurogenic bladder dysfunction. With particular references to neural control of micturition

Ryuji Sakakibara, M.D., Ph.D.1), Masahiko Kishi, M.D., Ph.D.1), Yohei Tsuyusaki, M.D.1), Fuyuki Tateno, M.D.1), Tomoyuki Uchiyama, M.D., Ph.D.2) and Tatsuya Yamamoto, M.D., Ph.D.3)

1)Neurology, Internal Medicine, Sakura Medical Center, Toho University
2)Continence Center, Dokkyo Medical College
3)Neurology, Chiba University

Bladder dysfunctions are one of the most common features seen in the failure of the autonomic nervous system. Among those, overactive bladder (urinary urgency and frequency) worsens quality of life of the patients, and a large amount of post-voiding residual urine or urinary retention causes urinary tract infection, kidney dysfunction, and may bring renal failure. In the present paper we discussed neural control of micturition and how to assess it. Also, we proposed appropriate management of bladder dysfunction in elderly white matter lesions (a common cause of OAB) and diabetic neuropathy (a usual pathology underlying urinary retention). For OAB, anti-cholinergics are the mainstay, whereas for the pathological post-voiding residual urine or urinary retention, alpha-blockers, cholinergic agents and clean, intermittent self-catheterization are the choice. Treatment of bladder dysfunctions is the important target for maximizing patients' quality of life.
Full Text of this Article in Japanese PDF (3938K)

(CLINICA NEUROL, 53: 181|190, 2013)
key words: neurogenic bladder dysfunction, overactive bladder, post-void residual, autonomic dysfunction

(Received: 10-Oct-12)