The diagnosis of neurogenic bladder consists of two parts: firstly, it should be clarified whether the voiding dysfunction is caused by neuropathy, and secondly, which type of neurogenic bladder it belongs to. Whether urinary dysfunction is caused by neuropathy 1. Medical history ① urinary dysfunction with defecation dysfunction (e.g. constipation, fecal incontinence, etc.), there is a possibility of neuropathic neurogenic bladder. ② Note any history of trauma, surgery, diabetes mellitus, poliomyelitis, or history of drug application. ③ Pay attention to whether there is a decrease or loss of sensation such as the urge to urinate, bladder distension, etc. If there is a significant decrease or increase in the loss of bladder sensation, the diagnosis of neurogenic bladder can be confirmed. 2. Examination ① Neurogenic bladder can be diagnosed when there is decreased sensation in the perineum and decreased or increased tone of the anal sphincter, but the lack of these signs cannot exclude the possibility of neurogenic bladder. ② Note the presence of spina bifida, spinal bulge, sacral dysplasia and other deformities. ③There is residual urine without mechanical obstruction of the lower urinary tract. ④Electrical stimulation spinal reflex test, this method mainly tests whether the spinal reflex arc nerves of the bladder and urethra are intact (i.e., whether the lower motor neurons have lesions or not) and whether the neurons from the cerebral cortex to the nucleus of the pudendal nerve (spinal cord center) have lesions or not (whether the upper motor neurons have lesions or not). Therefore, this test can diagnose neurogenic bladder and distinguish between lower motor neuron lesions (no reflexes in the urethra) and upper motor neuron lesions (hyperreflexia in the urethra). Second, the method of identifying two kinds of neurogenic bladder 1. In the measurement of intravesical pressure, observe whether there is no inhibitory contraction; if necessary, use the standing position of pressure measurement, coughing, pulling the catheter and other stimulation methods. If there is no inhibitory contraction, that is, the urethral muscle hyperreflexia category. Otherwise, it belongs to the category of urethral muscle no reflex. This test is one of the main basis for classification, but: ① bladder inflammation, stones, tumors and lower urinary tract obstruction (such as prostate hyperplasia), non-neurogenic bladder patients can also appear uninhibited contraction. ② urethral hyperreflexia patients in the supine position when the pressure measurement, some patients need to stimulate the emergence of uninhibited contraction. 2. Ice water test: After emptying the bladder with F16 catheter, quickly inject 60ml of 14℃ ice water. If the department of forced urethral muscle reflex hyperactive bladder, in a few seconds, ice water (such as together with the catheter) from the urethra was ejected; forced urethral muscle reflex bladder, ice water from the catheter slowly Han out. 3. anal sphincter muscle tone anal sphincter relaxation of the forced urethral muscle reflex is not a category. 4. Urethral closure pressure Maximum urethral closure pressure is normal or higher than normal for those who have hyperreflexia of the urethra, and maximum urethral closure pressure is lower than normal for those who have no urethral reflex. 5. Urethral resistance measurement Normal urethral resistance is 10.6kPa (80mmHg). The urethral resistance is 10.6kPa (80mmHg). The urethra of those who have no reflex is lower than normal. Among the above tests, it is more accurate to observe whether there is inhibitory contraction or not, while other tests have more chances of error. Errors may be due to the “mixed” lesion category (Bors classification) of neurogenic bladder, i.e., neuropathy of the urethral muscles is not at the same level as neuropathy of the external urethral sphincter.