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Bladder and Sexual Dysfunction

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Bedside Approach to Autonomic Disorders

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Abstract

Urinary function consists of a “storage” phase, in which tonic activation of urethral sphincter muscle occurs and bladder detrusor muscle is inhibited, and a “voiding” phase, in which detrusor activation and sphincter relaxation favor passing of urine. Both are under voluntary and involuntary neural control. Disorders of neural control of urinary function are also known as “neurogenic bladder” or “neurogenic lower urinary tract dysfunction.” Four main clinical pathological patterns can be distinguished at examination, with different therapeutic implications [27]:

  1. 1.

    Bladder detrusor overactivity: bladder storage capacity is reduced, but no or only low urine post-void volume occurs.

  2. 2.

    Detrusor sphincter dyssynergia: bladder storage capacity is reduced. Lack of coordination between bladder detrusor activation and urethral sphincter relaxation additionally induces post-void residual urine.

  3. 3.

    Hypoactive bladder: bladder capacity is increased. Insufficient detrusor activation leads to high post-void residual urine.

  4. 4.

    Hypoactive sphincter: bladder storage capacity is reduced, with no post-void residual urine.

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Acknowledgments

JNP undertook this work at UCLH/UCL Institute of Neurology and is supported in part by funding from the United Kingdom’s Department of Health NIHR Biomedical Research Centres funding scheme.

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Authors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, Anichstrasse 35, A-6020, Innsbruck, Austria

    Alessandra Fanciulli MD, PhD, Sabine Eschlböck & Gregor K. Wenning

  2. Department of Urology, Innsbruck Medical University, Innsbruck, Austria

    Gusztav Kiss

  3. The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, Queen Square, London, UK

    Jalesh N. Panicker

Authors
  1. Alessandra Fanciulli MD, PhD
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  2. Gusztav Kiss
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  3. Sabine Eschlböck
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  4. Gregor K. Wenning
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  5. Jalesh N. Panicker
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Corresponding author

Correspondence to Alessandra Fanciulli MD, PhD .

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Editors and Affiliations

  1. Chair, Department of Neurology, Karl Landsteiner University of Health Sciences, Site Tulln, Tulln, Austria

    Walter Struhal

  2. Private Office, Vienna, Austria

    Heinz Lahrmann

  3. Division of Clinical Neurobiology, Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Alessandra Fanciulli

  4. Division of Clinical Neurobiology, Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Gregor K. Wenning

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Fanciulli, A., Kiss, G., Eschlböck, S., Wenning, G.K., Panicker, J.N. (2017). Bladder and Sexual Dysfunction. In: Struhal, W., Lahrmann, H., Fanciulli, A., Wenning, G. (eds) Bedside Approach to Autonomic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-05143-7_5

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  • DOI: https://doi.org/10.1007/978-3-319-05143-7_5

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