Patients with neurological disease such as multiple sclerosis, Parkinson's disease, etc. often have voiding dysfunction (urinating problems) ranging from incontinence (leakage) to incomplete emptying to retention (inability to urinate). They can also have dyssynergia (the sphincter muscles and bladder muscle working against each other rather than in a coordinated fashion) or poor bladder compliance (elasticity), either of which can sometimes cause kidney damage.
Aside from causing adverse health problems, urinary problems are a major source of frustration in this patient population. Accurate diagnosis can prevent renal complications, while therapeutic options can provide social continence. The schematic below illustrates the complexity of the nerve supply of the lower urinary tract. The voiding cystourethrogram below shows the bladder of a patient with neurologic disease causing detrusor sphincter dyssynergia leading over time to significant thickening of the bladder wall, changes in bladder compliance, and the formation of multiple diverticulae.