Stroke, Parkinson's disease, and most forms of spinal-cord injuries

Surgery on the spinal cord, sacral spinal tumors, or congenital defects

Damage to the nerves that govern the urinary tract Damage to the nerves that govern the urinary tract impaired bladder function Impaired bladder function interruptions in the nerve pathways to the bladder occurring above the sacrum (five fused spinal vertebrae located just above the tailbone or coccyx)

Leads to the result of interrupted bladder stimulation at the level of the sacral nerves

Loss of sensation and motor control

NEUROGENIC BLADDER Overactive (Spastic or HyperReflexive Type)

NEUROGENIC BLADDER (Flaccid, Underactive Type)

Spontaneous nerve impulses to the bladder trigger spastic unexpected bladder contractions, resulting in accidental voiding of sometimes large amounts of urine

The bladder may become flaccid and distended and cease to contract fully

Bladder has a capacity that is extremely large (up to 2000 ml) due to a loss of the sensation of bladder filling

Low volume, high pressure

High volume, low pressure

Characterized by uncontrolled, frequent expulsion of urine from the bladder reduced bladder capacity incomplete emptying of urine

The bladder does not contract forcefully

Small amounts of urine dribble from the urethra as the bladder pressure reaches a breakthrough point

Resulting in only partial emptying and continual dribbling of small amounts of urine

Symptoms of overactive bladder:  Having to urinate too often in small amounts  Problems starting to urinate or emptying all the urine  Loss of bladder control

Symptoms of underactive bladder:  Bladder becomes too full and you may leak urine  Problems starting to urinate or emptying all the urine  Unable to tell when the bladder is full  Urinary retention

Allows residual bacteria to overwhelm local bladder mucosal defenses

Accumulation of bacteria that is aggravated if the bladder does not empty completely upon urination

Resulting to Urinary Tract Infection

Signs and symptoms: A strong, persistent urge to urinate A burning sensation when urinating Passing frequent, small amounts of urine Urine that appears cloudy Urine that appears bright pink or cola colored (a sign of blood in the urine) Strong-smelling urine Pelvic pain, in women Rectal pain, in men

Recurrent Urinary Tract Infection due to bladder residue Aggravate damage to the Neurogenic Bladder through processes of transmural inflammation and fibrosis

Group A Beta-Hemolytic Streptococcus

Produces Streptolysin O

Rashes may erupt in areas of the skin irritated by urine

A hemolytic factor

Stroke, Parkinson's disease, and most forms of spinal-cord injuries

Damage to the nerves that govern the urinary tract

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Impaired bladder function interruptions in the nerve pathways to the bladder occurring above the sacrum (five fused spinal vertebrae located just above the tailbone or coccyx)

Loss of sensation and motor control

NEUROGENIC BLADDER Overactive (Spastic or HyperReflexive Type)

Spontaneous nerve impulses to the bladder trigger spastic unexpected bladder contractions, resulting in accidental voiding of sometimes large amounts of urine

Low volume, high pressure

Characterized by uncontrolled, frequent expulsion of urine from the bladder reduced bladder capacity incomplete emptying of urine