Neurogenic lower urinary tract dysfunctions are a common cause of urination disorders, such as difficulty voiding, incontinence, and overactive bladder. Spinal injury, cerebrovascular accidents, multiple sclerosis, and dementias are the most common causes of neurogenic lower urinary tract dysfunction. The clinical picture may vary significantly in different types of neurogenic lower urinary tract dysfunction. The essence of this disease consists in detrusor and urethral sphincter muscle dysfunction in the form of either overactivity or underactivity. The diagnosis should involve precise neurological assessment, which is often of key importance for determining the aetiology. Urodynamic testing allows for an objective evaluation of lower urinary tract function. It is currently believed that upper and lower urinary tract protection and improving the quality of life of patients should be the primary treatment goals. Conservative treatment is mainly based on antimuscarinics (cholinolytics), which reduce the resting tension and the frequency of uncontrolled muscle contractions, thus limiting bladder overactivity. Minimally-invasive treatment methods for overactive bladder include botulinum toxin injections into the bladder detrusor muscle and intravesical infusion of cholinolytics. Intermittent catheterisation is considered the gold standard of care for voiding dysfunction. Some patients require surgical management – cystoplasty or urinary diversion. Since neurogenic bladder poses diagnostic and therapeutic difficulties, cooperation between general practitioners, urologists, and neurologists is crucial.

neurogenic lower urinary tract dysfunctions, neurogenic bladder, urinary incontinence, voiding disorders