Neurourological disorders

What is a neurourological disorder?

The nervous system connects the brain and spinal cord to all parts of the body through a network of nerves. A disturbance in that network can cause problems storing and passing urine. Urinary problems caused by the nervous system are called neurourological disorders.

What is neurogenic lower urinary tract dysfunction?

The lower urinary tract consists of the bladder and urethra and includes the prostate in men (Figure 1). The bladder stores the urine produced by the kidneys. It is a hollow stretchy bag made of muscle tissue that sits on the pelvic floor muscles. Normally the bladder is able to store urine without building up high pressure. Below the bladder, the urinary sphincter helps store the urine and prevent leakage. It is composed of different parts and muscle layers. The urethra is the tube through which urine passes from the bladder out of the body.

The main functions of the lower urinary tract are storing and passing urine. Both functions are regulated by the nervous system, which coordinates interaction of the bladder and the sphincter. For normal storage, the bladder muscle should be relaxed and the sphincter muscles tense. For urination, the bladder muscle should contract to build up pressure and to press the urine out, and the sphincter should relax to allow for easy and complete emptying without resistance.

These functions involve many parts of the nervous system, including the brain, the spinal cord, and the peripheral nerves. Any disturbance of these parts can lead to malfunction of normal storage and voiding and cause many symptoms. This disturbance is called neurogenic lower urinary tract dysfunction.

You may have a neurogenic lower urinary tract dysfunction if you also have one or more of the following conditions:

  • A neurologic disease such as dementia, stroke, or multiple sclerosis
  • Previous surgery or injury to the spine or pelvis
  • Previous radiation
  • Deformity of the spine
  • A slipped disc
  • A brain tumour or abnormal cell growth that affects the nervous system
  • Diabetes
  • Numbness or pain in the hands or feet (called peripheral neuropathy)

Questions to ask your doctor

Because neurourological disorders can present in many different ways, a specific diagnosis and therapy is important. EAU Patient Information gives you an overview of the possibilities.

You will have questions specific to your individual situation. Your doctor is the person to answer these questions. It can be helpful to prepare a list of questions before you see your doctor.

Here are some questions you might want to ask:

  • Why do I have this problem?
  • What are the risks of my condition?
  • What can I do to prevent complications and worsening of the situation?
  • Which treatment option do you recommend for me?
  • What can I expect from that treatment?
  • What are the possible side effects or risks of this treatment?
  • What treatment alternatives exist?
  • What are the benefits and drawbacks of the treatment options?

This information was produced by the EAU Patient Information Working Group, March 2017.

  • Dr. P. Honeck, Bensheim (DE)
  • Dr. J-P. Jessen, Sindelfingen (DE)
  • Dr. R. Pereira e Silva, Lisbon (PT)