QS Study

Atonic or Neurogenic Bladder

The bladder which is unable to urinate due to lack of muscular tone is called Atonic or Neurogenic Bladder. It is a term applied to urinary bladder malfunction due to neurologic dysfunction emanating from internal or external trauma, disease, or injury.

Cause: Destruction of sensory nerve fibers from the bladder to the spinal cord leads to the atonic bladder. It occurs due to a nerve-signaling problem that may occur after a stroke, spinal injury, or tumor. The condition causes the bladder to be in one of three states: flaccid, spastic, or a mix of the two.

Fig: Atonic Bladder

Overflow incontinence is the primary symptom in patients with a flaccid bladder. Patients retain urine and have constant overflow dribbling. Men typically also have erectile dysfunction. There is a lack of stretch signals from bladder preventing micturition reflex contractions. Therefore, instead of getting emptied periodically, bladder fills to its capacity and overflows.

Atonic bladder occurs commonly in syphilis (tabes dorsalis) when the bladder is known as the tabetic bladder. It is a large dilated urinary bladder that does not empty, usually due to a disturbance of innervation or to chronic obstruction.

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