Automatic Bladder

Automatic bladder is a sign of complete spinal cord lesions above cauda equina (above the sacral roots S2- S4) or above T12 vertebrae level. But the reflex arc is intact therefore small amout of urine causes oversensitivity  and sends impulses to the spinal cord through reflex arc and as a result external sphincter relaxes causing voiding of urine. There is increased urine frequency and small bladder volumes.
Hence upper motor neuron injury in such cases with sparing of reflex arc... causes reflex bladder and urge incontinence.
Apart from medications, the important part of treatment is :

• biofeedback
• kegel's exercises.

Kegel's exercises train the pelvic floor muscles and thus resist the urge to void.