What is the role of sacral cord injuries in the pathogenesis of neurogenic bladder?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

Selected injuries of the sacral cord and the corresponding nerve roots arising from the sacral cord may prevent the bladder from emptying and the patient from sensing a full bladder. Perosns who cannot sense a full bladder may be at risk for urinary retention and damage to the kidneys from the high pressure from storage of large urine volumes.

If the bladder cannot contract, a condition called detrusor areflexia is present, which also leads to the storage of large urine volumes and can be accompanied by overflow incontinence. Typical causes are a sacral cord tumor, herniated disc, and injuries that crush the pelvis. This condition also may occur after a lumbar laminectomy, radical hysterectomy, or abdominoperineal resection in some cases. Rapid growth in childhood can also lead to detrusor areflexia from a tethered spinal cord in patients with prior trauma or congenital malformations such as spina bifida.


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