Which medication class may reduce urinary retention in neurogenic bladder?

• A. Anticholinergic agents
• B. Cholinergic agents
• C. Alpha blockers
• D. Diuretics

Answer: (B)

Cholinergic agents help by directly stimulating the detrusor muscle to contract. In neurogenic bladder, the nerves that tell the bladder to contract are damaged, leading to poor detrusor activity and urinary retention. A parasympathomimetic drug activates muscarinic receptors on the detrusor, increasing its contractions and promoting bladder emptying, which reduces the amount of urine left in the bladder after voiding. Anticholinergic drugs do the opposite by blocking those receptors and would worsen retention. Alpha blockers may ease urine flow if there’s outlet obstruction, but they don’t restore detrusor contractility. Diuretics increase urine production and don’t improve voiding. So boosting detrusor contraction with a cholinergic agent directly addresses the underlying problem and reduces urinary retention.