Acontractile detrusor

For prognostic and therapeutic reasons, only functional classifications based on the reflex activity of the different muscle groups involved in storing and evacuating urine should be used. One commonly used classification is based primarily on the reflex activity of the detrusor muscle, defining three types contractile detrusor (detrusor hyperreflexia), acontractile detrusor (detrusor areflexia), and intermediate detrusor (mixed type). 

In acontractile bladders (detrusor areflexia), no signs of radiologically detectable detrusor contractions can be found. The bladder neck is open during the entire filling phase in these cases. Sphincter-weakness incontinence is indicated by leakage around the catheter, usually during the rise in intraabdominal pressure or coughing. 

The bladder neck is usually competent in infants and children with contractile detrusors, whereas it is mostly nonobstructive and incompetent in children with intermediate or acontractile bladders at their usual bladder volumes. 

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