Neurogenic dysfunction of the lower urinary tract (neurogenic bladder)

Abstract

The lecture presents information about the central and peripheral structures that provide innervation and regulation of the functions of the lower urinary tract — the bladder and urethra. The mechanisms of regulation of the functions of accumulation and retention of urine (reservoir function) and emptying of the bladder (evacuation function) are shown.Neural control of urination is organized in the form of a hierarchical system. The spinal centers are the executive structures, and the cerebral centers are the controlling structures. Involuntary implementation of the act of urination occurs through segmental sympathetic and parasympathetic mechanisms. The regulation of these functions and voluntary urination are carried out by the central mechanisms of the brain — the actuation of the urination reflex is under strict volitional control, which makes it possible to plan the emptying of the bladder in a socially acceptable place and time.The information on the clinical symptoms of neurogenic dysfunction of the lower urinary tract (neurogenic bladder) is reviewed. The features of clinical manifestations depending on the level of damage to neural structures and in various neurological diseases are shown. Methods for assessing urodynamics and treatment directions for neurogenic dysfunction of the lower urinary tract are presented.