Why may people with spinal cord pathology become incontinent?
In brief, spinal cord pathology may cause (1) Neurogenic detrusor overactivity (2) Detrusor sphincter dyssynergia (supra-sacral lesions) (3) Detrusor underactivity and impaired bladder sensation (usually sacral lesions) (4) Poorly sustained detrusor contractions (5) Combinations of these Any of these abnormalities may cause incontinence. Increased bladder pressures may occur with detrusor-sphincter dyssynergia or with reduced bladder compliance resulting from some sacral cord lesions, leading to the risk of upper tract dilatation and progressive renal impairment, particularly in those with spinal cord injury.
