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 a 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. What are the examination methods for structural and functional impairment of the upper urinary tract? 1. Physical examination (1) Anal sphincter tone test Anal sphincter relaxation indicates inactivity or reduced activity of the spinal center, and excessive contraction of the anal sphincter indicates hyperreflexia of the spinal center. (2) Anal reflex test stimulates the skin around the anus, and if the anus contracts, it indicates the presence of spinal cord activity. (3) The ball cavernosus muscle reflex test stimulates the head of the penis or clitoris and causes the anal sphincter to contract, indicating the presence of spinal cord activity. 2.Ice water test If the spinal cord is injured above the center, after injecting ice water into the bladder, the ice water will be forcefully ejected within a few seconds; if the spinal cord is injured below the center, there is no such response. 3.Urodynamic test It can reflect hyperreflexia of the forced urinary muscle or no reflex of the forced urinary muscle and the function of the urethral sphincter. 4, excretory cystourethrography can see the formation of trabeculae in the bladder wall, diverticulae and typical Christmas tree-like bladder, abnormal contraction of the detrusor muscle, abnormal coordination between the detrusor contraction and the internal and external urethral sphincter, and increased residual urine volume, etc. can be seen in dynamic observation. 5.CT, MRU and nuclear examination Can clearly show the anatomical and functional information of the upper urinary tract. 6, Cystourethroscopy It can understand the morphology of the vesicourethra, the presence of vesicoureteral reflux in the wound, etc. A series of imaging examinations, such as intravenous urography (excretory urography), ultrasonography, cystography and urethrography, CT and MRU, can help evaluate the degree of damage and disease progression secondary to neurogenic bladder and can show urinary tract stones. Cystourethroscopy can determine the degree of bladder outflow tract obstruction, and a series of intravesical pressure tracings performed during recovery from hypotonic bladder can provide an index of functional capacity of the detrusor muscle, which in turn indicates the prospects for recovery. Urodynamic measurements, electromyography of the sphincter, and urethral manometry are useful for diagnosis. Renal function tests, which respond to the degree of impaired function of the upper urinary tract. Urinalysis may be positive for red blood cells, white blood cells and urine culture in cases of combined urinary tract infection.