Posing as Ascites: A Case Report on Neurogenic Lower Urinary Tract Dysfunction

Lower urinary tract dysfunction (LUTD) is often overlooked, especially when it stems from neurological causes without obvious neurological symptoms. This case highlights the importance of checking the nerves that control the bladder and sphincters to diagnose neurological causes of bladder issues. The patient's symptoms initially suggested ascites (fluid in the abdomen), but a thorough neurological exam revealed the true cause: nerve damage affecting bladder function.

• 1
  The patient presented with abdominal pain, urinary straining, slow/intermittent stream, and stress incontinence, initially mistaken for ascites.
• 2
  Neurological examination revealed diminished anal sphincter tone, diminished voluntary anal contraction, and absent left anal reflex.
• 3
  Urodynamic study confirmed lower motor neuron bladder dysfunction with absent voluntary detrusor contraction and elevated residual volumes.