Nocturnal incontinence following radical cystectomy with orthotopic neobladder formation is most commonly attributed to what physiologic mechanism?
Explanation
Isolated nocturnal incontinence after RC/neobladder is due to loss of afferent sensory input from the detrusor to the CNS. Normally, bladder filling signals the CNS to reflexively increase urethral sphincter pressure — this protective reflex is absent in neobladder patients and cannot be restored.
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