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 induced urinary complications are a major cause of death in patients. What can cause structural and functional damage to the upper urinary tract? 1. Diabetes mellitus Long-term diabetic patients have increased vascular resistance in the nerve endothelium due to disorders of glucose metabolism, causing ischemia and hypoxia, resulting in nerve cell and nerve axon degeneration and nerve fiber demyelination changes. The density of neurons in the bladder wall becomes diluted, the axons have degenerative lesions and nerve fragments, and the afferent and efferent fibers of the bladder are impaired in conducting impulses, resulting in dysfunction of the vesicourethra. Impaired bladder function is one of the common complications in diabetic patients, with a prevalence of 43% to 87% in type I diabetic patients. 2.After pelvic organ resection, such as radical rectal cancer surgery and radical uterine cancer surgery, abnormal urination often occurs after surgery, with an incidence of 7.7% to 68%. It has been confirmed that this is due to damage to the parasympathetic nerve, sympathetic nerve, pelvic ganglion and pubic nerve in the pelvis. 3. Herpes zoster The herpes zoster virus is latent in the cells of the posterior horn of the spinal cord and spreads along the nerve sheath, destroying the nerves. When the lumbar or sacral nerves are involved, urinary frequency and urinary retention can occur. There are many ways to classify neurogenic bladder, but the common classification used in the past was the Bors classification, which classified the following 5 categories: (1) upper motor neuron lesions lesions above the central spinal cord (S2-S4), including sensory and motor branches. (2) Lower motor neuron lesions are located in the central spinal cord (S2 to S4) or in the peripheral nerves below the central spinal cord, including sensory and motor branches. (3) Primary motor neuron lesions are limited to the motor branches, with no lesions in the sensory branches, as in poliomyelitis. (4) Primary sensory neuron lesions are limited to sensory branches. Motor neuron lesions, such as diabetes mellitus and neurogenic bladder caused by spinal consumption. (5) Mixed lesions related to voiding autonomic motor neuron lesions (parasympathetic) and somatic motor neuron lesions are not at the same level, where one is in the upper motor neuron and the other in the lower motor neuron, or one has a lesion and the other has no lesion. This classification, although more exhaustive, is too complex and lacks guidance for the choice of treatment. In recent years, the international community has divided the bladder into two categories according to whether there is uninhibited contraction of the detrusor muscle during bladder filling: 1. Hyperreflexia of the detrusor muscle in response to stimulation has hyperreflexia, and uninhibited contraction occurs during measurement of intravesical pressure. This may or may not be accompanied by dysfunction of the urethral sphincter. In this group of neurogenic bladder, there is no reflex or hyporeflexia of the detrusor muscle in response to stimulation. There is no uninhibited contraction during the measurement of intravesical pressure. It may or may not be accompanied by dysfunction of the urethral sphincter.