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To the Editor.—
I am writing to comment briefly on recommendations made by F. A. Fried, MD, in answer to the patient complaint of urinary frequency, urgency, and nocturia in the absence of bladder, prostatic, or urethral inflammatory disease (239:545, 1978).While the patient's complaints are reminiscent of classic neurogenic bladder, similar or identical histories are also consistent with lower motor neuron disease, such as occult discogenic disease. I fully agree with Dr Fried's third recommendation that the patient have neurological studies of the bladder and urethra and have neurological examination for any neurological deficits. Consideration during this neurological examination not only should be to sacral roots 2, 3, and 4, the general level of supply to the bladder, but also should include a screen of spinal cord function to look for occult myelopathy. Lower motor neuron disease, as an expression of herniated lumbar disc without back pain or sciatica,
Schossberger PF. Diagnosis of Urinary Frequency. JAMA. 1978;240(4):347-348. doi:10.1001/jama.1978.03290040025014