Nonneurogenic neurogenic bladder

A broad spectrum of terms such as nonneuro-pathic vesicourethral dysfunction (Koff 1984), overactivity of the bladder and striated urethral muscle (Van Gool et al. 1984), nonneuropathic or nonneurogenic bladder-sphincter dysfunction (Hoebeke et al. 1999), dysfunctional bladder (Hinman 1986), unstable bladder (Koff 1982), nonneurogenic neurogenic bladder (Allen 1977) and Hinman syndrome (Hinman 1986) is still in use for sometimes overlapping patterns of nonneurogenic bladder-sphincter dysfunction. 

Nonneurogenic neurogenic bladder or the so-called Hinman syndrome is at the extreme end of the spectrum of nonneurogenic bladder-sphincter dysfunction. This syndrome shows severe clinical manifestations including urinary retention, severe bladder-sphincter dysfunction, VUR, hydronephrosis and hydroureter and renal scarring. 

Bauer et al. (1980) found that the majority of children with urinary tract dysfunction had unstable bladder and only a small number had the severest type of dysfunction, which is called nonneurogenic neurogenic bladder (Allen 1977). 

VUD is the combination of VCU with pressure/ flow/electromyographic studies of the lower urinary tract. It is the gold standard for the assessment of children with neurogenic bladder. It is only a second-step study in children with nonneurogenic bladder-sphincter dysfunction. 

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