What would be a differential diagnosis for a lower motor neuron bladder?

A lower motor neuron bladder typically results from lesions affecting the sacral spinal cord or the lower motor neurons innervating the bladder. This condition often leads to bladder atony and retention, as the nerves that stimulate bladder contraction are impaired.

Intervertebral disc disease is a compelling differential diagnosis because it can lead to compression of the spinal cord or nerves that control bladder function, particularly in the lumbosacral region. If a disc herniates and compresses the relevant nerve roots, it can result in a lower motor neuron pattern of bladder dysfunction. This can manifest as an inability to effectively contract the bladder, presenting symptoms such as urinary retention or incontinence.

While urinary tract infections, kidney stones, and bladder tumors may all affect bladder function, they do not specifically indicate lower motor neuron involvement. Infections and obstructions often lead to different types of bladder dysfunction, which are more reflective of upper motor neuron problems when there is urgency or spasticity rather than the flaccidity associated with a lower motor neuron bladder. Understanding these distinctions is crucial in accurately diagnosing and managing urinary disorders.