Lower urinary tract dysfunction may result from a variety of neurologic disorders, including traumatic spinal cord injury, head injury, a cauda equina syndrome, or trauma to the peripheral lumbosacral nerves. A careful neurourologic assessment is required to determine the cause and the severity of urinary incontinence.
Urinary incontinence can be divided into 5 categories, as illustrated in Table 1. The evaluation of neurogenic bladder dysfunction commences with a thorough history, physical examination, and routine diagnostic tests for renal function. Evaluation of voiding dysfunction should not be based on symptoms alone; urodynamic evaluation is also required. Historical information includes information relevant to voiding (with completion of a bladder diary, a voiding frequency/volume chart), neurological difficulties, congenital anomalies, previous urinary infections and surgery, medications, and review of systems. Physical examination includes evaluation of genitourinary structures and a comprehensive neurological...
