This summary addresses neurogenic bladder. For discussion of other types of incontinence, see urinary incontinence. 

Neurogenic incontinence (neurogenic bladder) is described as lack of bladder control due to brain, spinal cord, or nerve issues. There is a two-way pathway between these locations and the bladder. If these pathways are disrupted, it can cause the bladder to either tighten or relax at inappropriate times. Risk factors include brain / spine trauma, multiple sclerosis, Parkinson disease, spina bifida, major pelvic surgery, neural tube defects, cerebrovascular accidents, brain tumors, and peripheral neuropathy in the setting of type 2 diabetes mellitus and AIDS. Neurogenic bladder is often suspected clinically in patients with characteristic symptoms and a predisposing condition. A thorough history and urodynamic testing can confirm the diagnosis.

Neurogenic bladder occurs with impaired coordination of urinary bladder detrusor muscle contraction and internal and external urethral sphincter relaxation. This may be due to dysfunction of the central, peripheral, or autonomic nervous system involved in the control of micturition, resulting in urinary dysfunction. Neurogenic bladder describes a spectrum of phenotypes depending on the location of the neurologic injury.

Lesions from the brain down through the cervicothoracic spinal cord cause an upper motor neuron (ie, spastic) bladder phenotype. Damage to sacral nerve roots leads to a lower motor neuron (ie, flaccid) phenotype. Sacral spinal cord lesions may cause mixed bladder phenotypes, with spastic and flaccid components.

Symptoms are variable and include urinary incontinence, small urinary volume, difficulty initiating urinary stream, incomplete bladder emptying, changes in urinary frequency or urgency, inability to sense bladder fullness, recurrent urinary tract infections, and dysuria.