What is the role of stroke in the etiology 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

After a stroke, the brain may enter into a temporary acute cerebral shock phase. During this time, the urinary bladder will be in retention—detrusor areflexia. Almost 25% of affected individuals develop acute urinary retention after a stroke.

After the cerebral shock phase wears off, the bladder demonstrates detrusor hyperreflexia with coordinated urethral sphincter activity. This occurs because the PMC is released from the cerebral inhibitory center. Patients with detrusor hyperreflexia complain of urinary frequency, urinary urgency, and urge incontinence.

The treatment for the cerebral shock phase is indwelling Foley catheter placement or clean intermittent catheterization (CIC). Detrusor hyperreflexia is treated with anticholinergic medications to facilitate bladder filling and storage.


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