Neurogenic bladder (NB) is a general term for a group of disorders in which neurological lesions lead to bladder and M or urethral dysfunction (i.e., urinary storage and M or voiding dysfunction), resulting in a range of lower urinary tract symptoms and complications. 1, neurogenic bladder is not a single disease, all neurogenic lesions (including central and peripheral) that may affect the neuromodulatory processes related to urinary storage and M or voiding have the potential to affect bladder and M or urethral function. In cases of insidious etiology, every effort should be made to find the cause of the neuropathic lesion. (Highly recommended) 2. Differences in clinical symptoms and severity of neurogenic bladder do not always coincide with the severity of neurological lesions, so the type of bladder and urethral dysfunction cannot be conjectured solely on the basis of the type and extent of the primary neurological lesion. Neurogenic bladder is classified using the ICS classification system for lower urinary tract dysfunction based on urodynamic findings. (Highly recommended) 3. Urodynamic examination as the basis for classification of neurogenic bladder can elucidate the changes in the pathophysiology of the lower urinary tract and provide an objective basis for the development and adjustment of treatment plans and follow-up of treatment results. (Highly recommended) The treatment of neurogenic bladder is mainly to protect renal function and prevent pyelonephritis, hydronephrosis leading to chronic renal failure; secondly, to improve urinary symptoms in order to reduce their pain in life. The specific measures of treatment are to reduce the amount of residual urine using various non-surgical or surgical methods, which can reduce urinary complications after the residual urine volume is eliminated or reduced to very little (less than 50 ml). However, it must be noted that in a few patients, complications such as pelvic effusion, pyelonephritis, and decreased renal function occur even though the residual volume is minimal or even completely absent. Because of the strong contraction of the detrusor muscle during urination in these patients, the intravesical pressure can be as high as 19 or 72 kPa (200 cmH2O) or more (normal should be 6 or 9 kPa or less than 7 cmH2O). These patients should be treated early to relieve lower urinary tract obstruction. Several commonly used treatments are described below: Non-surgical treatment 1, intermittent catheterization or continuous drainage In the period of spinal shock after spinal cord injury or a large amount of residual urine or urinary retention, if the renal function is normal, intermittent catheterization is available. Initially, it is operated by medical personnel. If the patient is in good general condition, the patient can be trained to self-catheterize. Intermittent catheterization is more appropriate in women. If all surgical therapies are ineffective, home-based intermittent catheterization can be performed for life. If the patient’s general condition is poor or the kidney function is impaired, an indwelling catheter should be used for continuous drainage. 2.Medication Any patient with high bladder residual urine volume should first apply alpha-blockers to reduce residual urine, regardless of whether there are symptoms of reflex hyperactivity of the forceps urinaryis muscle such as urinary frequency, urinary urgency and urge incontinence. If alpha-blockers alone are not effective, drugs that increase bladder contraction such as uratine and neostigmine can be applied simultaneously. For patients with symptoms of hyperreflexia of the detrusor muscle (urinary frequency, urgency, and enuresis) without residual urine or with little residual can apply drugs that inhibit bladder contraction such as urinary polygamy, isoproterenol, and probenecid. For patients with mild stress urinary incontinence without residual urine can apply drugs that promote bladder neck and posterior urethra contraction such as ephedrine and insulin. For patients who can function with impairment, measures should be taken first to make urine drainage smooth, rather than applying drugs to improve urination symptoms. 3, acupuncture therapy Acupuncture has a good effect in treating sensory paralysis of the bladder due to diabetes, and is particularly effective for early lesions. 4, closed therapy This method is advocated by Bors and is suitable for upper motor neuron lesions (hyperreflexia of the detrusor muscle). It is not effective for motor neuron lesions (no reflexes in the forced urinary muscles). In patients with good results after closure, there is a significant reduction in residual urine volume and a marked improvement in voiding symptoms. In a small number of patients, the effect is maintained for several months to as long as 1 year after 1 closure. These patients require only regular earthworks and do not need to resort to surgery. Closure therapy is performed in the following order: ① Mucosal closure: the bladder is emptied with a catheter and 90 ml of 0, 25% pantocaine solution is injected and expelled after 10 to 20 minutes. ②Bilateral pubic nerve block. ③Selective sacral nerve block: block one pair of sacral nerves from S2 to 4 at a time. If there is no effect, a combined block of S2 and S4 and S4 can be performed. 5.Bladder training and dilatation This method can be used for those with severe symptoms of urinary frequency and urgency and no residual urine or very little residual volume. Ask the patient to drink water regularly during the day, 200ml per hour. try to extend the interval between urination, so that the bladder can be easily and gradually expanded.