Neurogenic bladder in DM

[lordman]

So neurogenic bladder in DM casuses urinary retention and high post void residual volume. Shouldn't the treatment be bethanicol or any other cholinergic drug? Why Emedicine lists anti-cholinergics?

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[Apoplexy__]

Neurogenic bladder refers to any neurological insult that disrupts bladder function -- it can be either hyper- or hypofunction. That is, "neurogenic bladder" can refer to either overactive bladder/urge incontinence or atonic bladder/overflow incontinence.

Overactive bladder medical therapy = Anticholinergics
Atonic bladder medical therapy = Cholinergics

 

[lordman]

Thank you!

 

[Phloston]

So neurogenic bladder in DM casuses urinary retention and high post void residual volume. Shouldn't the treatment be bethanicol or any other cholinergic drug? Why Emedicine lists anti-cholinergics?

Neurogenic bladder refers to any neurological insult that disrupts bladder function -- it can be either hyper- or hypofunction. That is, "neurogenic bladder" can refer to either overactive bladder/urge incontinence or atonic bladder/overflow incontinence.

Overactive bladder medical therapy = Anticholinergics
Atonic bladder medical therapy = Cholinergics

I would think DM neurogenic bladder almost invariably results in overflow incontinence (i.e., lack of detrusor function), since this is LMN. You wouldn't get hyperfunction unless the denervation were UMN, but that's not really a diabetic aetiology - more MS. Any DM patient I've seen in clinic with bladder issues, it's always overflow. No, you would not use anticholinergics in these patients and would be sitting in front of a judge if you did.

 

[Apoplexy__]

I would think DM neurogenic bladder almost invariably results in overflow incontinence (i.e., lack of detrusor function), since this is LMN. You wouldn't get hyperfunction unless the denervation were UMN, but that's not really a diabetic aetiology - more MS. Any DM patient I've seen in clinic with bladder issues, it's always overflow. No, you would not use anticholinergics in these patients and would be sitting in front of a judge if you did.

Ah -- my mistake, I didn't pay attention to the fact that OP was specifically asking for the case of DM. My point was to draw attention to the fact that I've seen "neurogenic bladder" as an answer choice for both hypo- and hyperfunction, which could explain why the sources he looked up conflicted on the treatment of "neurogenic bladder".

My bad, OP.