Neurogenic bladder pathophysiology, assessment and management after lumbar diseases

Neurogenic bladder (NB) is a group of bladder and/or urethral dysfunctions caused by neurological lesions, commonly seen in patients with lumbar spine diseases, manifesting as urinary storage and voiding dysfunction, significantly affecting patients' quality of life. Degenerative changes or trauma to the lumbar spine can lead to narrowing of the dural sac, compressing the sacral nerve roots, cauda equina or blood vessels, causing bladder dysfunction and leading to NB. Diagnostic methods for NB include history taking, physical examination and noninvasive and invasive tests, such as urodynamic testing and cystoscopy. The treatment goals for NB are to protect upper urinary tract function, restore or partially restore lower urinary tract function, improve urinary control, reduce residual urine volume, prevent urinary tract infections and improve patients' quality of life. Treatment methods include conservative treatment, pharmacological treatment, catheterization, neuromodulation and surgical treatment, which should be sequentially administered based on the patient's specific condition.