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Neurogenic Bladder and Sexual Dysfunction 

Neurogenic Bladder and Sexual Dysfunction
Chapter:
Neurogenic Bladder and Sexual Dysfunction
Author(s):

Eduardo E. Benarroch

and Michelle L. Mauermann

DOI:
10.1093/med/9780199920198.003.0011
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date: 31 July 2021

Neurogenic bladder, frequently in combination with neurogenic sexual dysfunction, is a prominent manifestation of many neurologic disorders, including midline frontal lesions, Parkinson disease (PD), multiple system atrophy (MSA), spinal cord injury (SCI), multiple sclerosis (MS), and peripheral autonomic neuropathies and ganglionopathies.. Lesions of the frontal lobes or basal ganglia circuits, such as PD, are associated with an uninhibited bladder characterized by detrusor overactivity. Spinal cord lesions above T10, such as in traumatic SCI or MS, produce spastic bladder characterized by detrusor overactivity and detrusor sphincter dyssynergia. Disorders affecting the pontine micturition center or the sacral preganglionic or somatic motoneurons, such as MSA, conus medullaris, or cauda equina produce a hypotonic bladder with urinary retention and overflow incontinence. The treatment of detrusor overactivity is anticholinergic drugs; the treatment of micturition disorders is clean, intermittent self-catheterization. Sexual dysfunction commonly coexists with bladder dysfunction in neurological disorders; endocrine, vascular, and psychological factors may have an important contributory effect.

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