Neurology and the bladder: how to assess and manage neurogenic bladder dysfunction. With particular references to neural control of micturition
Sakakibara R, Kishi M, Tsuyusaki Y, Tateno F, Uchiyama T, Yamamoto T. Rinsho Shinkeigaku. 2013;53(3):181-90.


Neurology, Internal Medicine, Sakura Medical Center, Toho 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.