What are the principles of diagnosis and treatment of neurogenic bladder?

  Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): Now the urinary catheter is inserted, the bladder nerve is not functional, and the nerve-nourishing fluids have been infused, with no improvement, to see if there is a good way not to insert the urinary catheter, and no other good way.  Yang Yong, Department of Urology, Beijing Chaoyang Hospital: Neurogenic bladder is complicated and requires imaging urodynamics to understand the functional state of the bladder urethra to determine the treatment plan. Simply put, the most important thing for neurogenic bladder is to prevent renal impairment. If the bladder has become fibrotic, bowel bladder enlargement plus clean intermittent self-catheterization is required; if the safe bladder volume is 400 ml (which needs to be confirmed by imaging urodynamics) or more, direct clean intermittent self-catheterization is sufficient. A basic understanding of neurogenic bladder is that 1. nerve damage is permanent and one should not expect that some treatment will completely restore the nerve to achieve the same bladder-urethral function as normal; 2. renal impairment is the most fatal comorbidity of neurogenic bladder and it occurs slowly and unknowingly and requires regular annual imaging urodynamics to assess the risk of renal impairment; 3. physicians cannot possible to restore a patient with neurogenic bladder to the same level as a normal person, but with the efforts of the physician, a level of protection of renal function and as normal a life as possible can be achieved.