Neurological bladder is a condition related to lower urinary tract dysfunctions, caused by neurological lesions that affect bladder control. Micturition physiology involves a complex system of coordination between the detrusor muscle, the sphincters, and the nervous system. Neurological alterations can lead to dysfunctions such as detrusor overactivity (urgency, frequency, incontinence) or detrusor underactivity (difficulty emptying, urinary retention).
Diagnosis requires a multidisciplinary approach, including tests such as avoiding diary, uroflowmetry, and urodynamics. Treatment includes medications (antimuscarinics, beta-3 agonists), intermittent catheterization, and botulinum toxin injections. Pelvic floor rehabilitation, used as an initial treatment, focuses on improving the strength and coordination of the perineal muscles. Techniques such as biofeedback, electrostimulation, and neuromodulation (tibial nerve stimulation and transcranial magnetic stimulation) are used to improve bladder function and continence. Electrical stimulation and neuromodulation regulate urethral pressure and muscle control, offering solutions for patients who do not respond to medications. Therefore, managing neurological bladder requires a personalized approach, with both pharmacological and rehabilitative treatments.