About myelomeningocele, what type of bladder is present in about 85% of patients?

About myelomeningocele, what type of bladder is present in about 85% of patients?

• A. Neurogenic
• B. Reflex
• C. Acontractile
• D. Overflow

Answer: (A)

When the spinal cord is disrupted in myelomeningocele, neural control of the bladder and external sphincter is lost. This produces a neurogenic bladder, the pattern most commonly seen in these patients. The lesion often leaves the reflex arc intact while removing higher-level voluntary control, so the bladder tends to contract reflexively (detrusor hyperactivity) with poor coordination to the sphincter (detrusor–sphincter dyssynergia). This neurogenic dysfunction is why about 85% of patients with myelomeningocele have a neurogenic bladder. Overflow would imply underactive detrusor or obstruction, and an acontractile pattern implies little to no detrusor contraction—neither of these best describes the typical MMC presentation. A reflex description can be part of the neurogenic picture, but the broad and correct category for this condition is neurogenic bladder.

When the spinal cord is disrupted in myelomeningocele, neural control of the bladder and external sphincter is lost. This produces a neurogenic bladder, the pattern most commonly seen in these patients. The lesion often leaves the reflex arc intact while removing higher-level voluntary control, so the bladder tends to contract reflexively (detrusor hyperactivity) with poor coordination to the sphincter (detrusor–sphincter dyssynergia). This neurogenic dysfunction is why about 85% of patients with myelomeningocele have a neurogenic bladder.

Overflow would imply underactive detrusor or obstruction, and an acontractile pattern implies little to no detrusor contraction—neither of these best describes the typical MMC presentation. A reflex description can be part of the neurogenic picture, but the broad and correct category for this condition is neurogenic bladder.