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Brain, Vol. 122, No. 7, 1213-1231, July 1999
© 1999 Oxford University Press

Invited Review

Neurological disorders of micturition and their treatment

Clare J. Fowler

Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, Institute of Neurology and Institute of Urology, UCL, London, UK

Correspondence to: Dr Clare J. Fowler, Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

An overview of the current concepts of the neurological control of the bladder is given, based on laboratory experiments and PET scanning studies in human subjects. This is followed by a description of the various causes of the neurogenic bladder, discussed in a hierarchical order starting with cortical lesions and descending through the basal ganglia and brainstem, spinal cord, conus and cauda equina to disorders of peripheral innervation. Then follows a description of the condition of isolated urinary retention in young women. The article concludes with a review of the methods available for treating neurogenic bladder disorders. These are largely medical but brief mention of appropriate surgical procedures is made.

neurogenic bladder; detrusor hyperreflexia; incontinence; urinary retention

CRD = complex repetitive discharge; CVA = cerebrovascular accident; DDVAP = desmopressin; MSA = multiple system atrophy; SPECT = single photon emission computed tomography


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