The normal voiding activity is participated by the spinal reflex center and sympathetic, parasympathetic, and somatic nerves. Damage to the central nervous system or peripheral nerves that control voiding function and cause vesicourethral dysfunction is called neurogenic bladder. There are two categories according to the function of the detrusor muscle: (i) hyperreflexia of the detrusor muscle; and (ii) absence of reflexes of the detrusor muscle. Neurogenic vesicourethral dysfunction is a group of dysfunctional disorders of the bladder and/or urethra caused by neuropathy or damage, often accompanied by coordinated malfunction of the vesicourethra. Neurogenic vesicourethral dysfunction produces complex voiding symptoms, with dyspareunia or urinary retention being one of the most common symptoms. The resulting urological complications are a major cause of death in patients. How to examine the structural and functional damage of the upper urinary tract? 1. Medical history (1) Those with urinary dysfunction with defecation dysfunction (such as constipation and fecal incontinence) have the possibility of neuropathic transsphenoidal bladder. (2) Note any history of trauma, surgery, diabetes mellitus, poliomyelitis, etc. or history of drug application. (3) Pay attention to the presence of hyperalgesia or loss of sensation such as urge to urinate, bladder expansion, etc. If there is significant hyperalgesia or increased loss of sensation of the bladder, the diagnosis of neurogenic bladder can be confirmed. 2, examination (1) The diagnosis of neurogenic bladder can be confirmed when there is hypoesthesia of the perineum and hypotonia or increased tone of the anal sphincter, but the lack of these signs does not exclude the possibility of neurogenic bladder. (2) Note the presence of spina bifida, spondylolisthesis, sacral dysplasia, and other deformities. (3) There is residual urine but no mechanical obstruction of the lower urinary tract. (4) Electrical stimulation of spinal reflex test, this method mainly tests whether the spinal reflex arc nerves of the bladder and urethra are intact (i.e., whether there are lesions in the lower motor neurons) and whether there are lesions in the neurons from the cerebral cortex to the nucleus accumbens (spinal cord center) (whether there are lesions in the upper motor neurons). Therefore, this test can diagnose neurogenic bladder and distinguish between lower motor neuron lesions (no reflexes in the detrusor muscle) and upper motor neuron lesions (hyperreflexia in the detrusor muscle).