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The contraction of the detrusor muscle causes the urinary bladder and its mass peristaltic movement, leading to micturition. The vesical plexus of nerves, composed of fibers from the inferior hypogastric plexus, supplies the urinary bladder. The brain plays a crucial part in developing and maintaining bladder control, although its specific involvement in urgency and urine leakage is not well understood. The critical components in the neural control of the bladder and its regulation are the pontine micturition center (located in the mediodorsal aspect of the pons) and the Onuf's nucleus, also known as the sacral micturition center (located between the sacral S2 and S4 segments). The most important cause of a neurogenic bladder is damage or lesions of the spinal cord affecting the pontine micturition center, Onuf's nucleus, or damage to the motor neurons between the pontine and the sacral centers of micturition. Neurogenic bladder can be of several types based on the location of the lesions, such as the autonomous bladder, spastic bladder, atonic bladder, and cortical bladder, all were presented with a unique clinical picture. The classical approach to a case of neurogenic bladder involves a complete assessment of the neurologic system and of pelvic anatomy, while neurogenic bladder rehabilitation may include a bladder retraining program involving intermittent catheterization, timed voiding, medications, and lifestyle modifications. This review article attempts to correlate the neurogenic bladder with various anatomical aspects related to the micturition center in the brain and spinal cord and their control over the urinary bladder, as well as the classical approach toward such a case of neurogenic bladder., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kumar et al.)

Micturitional disturbance is rarely mentioned in human herpetic brainstem encephalitis although the pontine tegmentum, called the pontine micturition centre, seems to regulate the lower urinary tract in experimental animals. The case of a 45 year old man, who developed subacute coma and hiccup-like dysrhythmic breathing, and needed assisted ventilation is reported. Examination of CSF showed mononuclear pleocytosis and antibody against herpes simplex virus type 1, but the opening pressure was 90 cm H2O. Brain CT showed brain swelling, predominantly in the posterior fossa, and bilateral subdural effusion. Herpetic brainstem encephalitis was diagnosed, and he received 900 mg/day vidarabine. On regaining consciousness, he had left trochlear nerve palsy, left corectopia, ageusia, and urinary retention. Brain MRI showed right side dominant, bilateral pontine segmental lesions extending slightly to the midbrain and medulla. After two weeks he was able to urinate but showed nocturnal urinary frequency, urinary incontinence, and voiding difficulty. Urodynamic studies showed a residual urine volume of 350 ml and detrusor hyporeflexia on voiding. Micturitional disturbance gradually disappeared together with the neurological signs. The bilateral pontine tegmental lesions in this patient are similar to those in previous findings on brainstem strokes, evidence of the presence of a pontine micturition centre in humans. [ABSTRACT FROM AUTHOR]