Causes of Spinal Cord Injury – Neurogenic Bladder include:

• Spinal cord injury
• Brain tumor
• Stroke 
• Congenital disorders such as spina bifida 
• Diseases such as multiple sclerosis or diabetes mellitus

Depending where the lesion or injury is, and its severity, a person may experience a variety of lower urinary tract symptoms such as:

• An inability to store urine – urgency, frequency and incontinence. This is caused by an overactive bladder or a weak sphincter (outlet)
• An inability to release urine – difficulty urinating and urinary retention. This is caused by a weak bladder or an overly tight sphincter.

Many patients will come to a urologist for these symptoms, unaware that they have a neurologic problem. Others will have other longstanding manifestations of neurologic disease.

Every neurogenic bladder is different and it is important to do a thorough evaluation to diagnose the disease so that treatment is specific and directed. Blood tests and ultrasound to evaluate the kidneys are important. Tests called uroflowmetry and post void residual tell how well the bladder empties. Urodynamic testing with video xray are performed by placing a small catheter in bladder and filling the bladder with radiopaque contrast dye. The pressure in the bladder is measured during filling and voiding, electromyography (EMG) records the activity in the external sphincter during voiding, and xray gives anatomic information about what happens in the bladder. With this test, a very specific diagnosis can be made about whether there is a problem with the bladder, the outlet or both.