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Neurogenic Bladder
Upper Motor Neuron Lower Motor Neuron
UMN Features
  • Small overactive spastic bladder
  • Failure to store urine
Treatments
  • intermittent catheterization (IC) for persons who can be trained
  • Medications that allow for urine storage:
    • Anticholinergics (e.g. oxybutynin, tolterodine)
    • β-3 stimulant (mirabegron)
    • Botulinum toxin
  • condom catheter (+/- tamsulolin) for reflex voiding
  • indwelling catheter for patient unable to perform IC
LMN Features
  • large areflexic, flaccid bladder
  • failure to empty
Treatments
  • IC for persons who can be trained
  • Credé manuever (exert manual pressure on the abdomen at the location of the bladder, just below the navel)
  • Valsalva maneuver
  • Indwelling catheter for patient unable to perform IC or persons unable to maintain continence between IC.
  • References

    Cardenas D, Ciodo A, Samson G. Management of Bladder Dysfunction. In: Braddom R, editor. Physical Medicine & Rehabilitation. 4th Edition ed. St. Louis, MO: Elsevier Health Sciences; 2014.

    Dorsher, P, McIntosh, P. Neurogenic bladder. Advances in Urology 2012:1-16.