In neurogenic bladder, spastic type is typically associated with which voiding pattern?

• A. Infrequent voiding
• B. Frequent voiding
• C. Complete retention with no urge
• D. Normal voiding

Answer: (B)

Spastic neurogenic bladder involves an overactive detrusor due to loss of voluntary control but preserved reflex pathways. The detrusor contracts involuntarily during filling (detrusor hyperreflexia), so the bladder reaches the urge to void at low volumes. This leads to frequent voiding with small amounts each time, and sometimes urge incontinence. In contrast, a flaccid type has a hypoactive or noncontractile detrusor, causing infrequent voiding with larger residuals. Normal voiding isn’t typical in neurogenic bladder patterns. So the pattern most associated with the spastic type is frequent voiding.