Micturition is the normal process of storage and voiding of urine. Disorders of micturition encompass problems with urine storage (i.e., leakage or incontinence) and bladder emptying (i.e., urine retention). Disorders of micturition can be divided into two major categories: those associated with a large, distended bladder, and those associated with a small (or normal-sized) bladder. Disorders associated with large bladders include neurogenic disorders (upper and lower motor neuron disease and reflexdyssynergia) and outflow obstructive disorders caused by anatomic abnormalities (e.g., urethral neoplasia or uroliths). Even though these large bladder disorders are associated with urine retention, paradoxically incontinence may also be present. Urine leakage (unless there is rupture of the bladder or urethra, which is rare) will occur in urine retention disorders when intravesicular pressure exceeds the outflow resistance. Micturition disorders associated with a small bladder include urge/inflammatoryand urethral sphincter mechanism incompetence (USMI) incontinence as well as congenital abnormalities of the urinary system (e.g., vaginal strictures and ectopic ureters).
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