Neurogenic Bladder

What is a neurogenic bladder?

The muscles and nerves of the urinary system work together to hold and release urine at the right time. Nerves carry messages between the bladder and the spinal cord and brain. The messages tell the bladder muscles to either tighten or release. With neurogenic bladder, a person does not have bladder control because of brain, spinal cord, or nerve problems.

What causes neurogenic bladder?

These are some possible causes of neurogenic bladder:

• Diabetes

• Infections

• Accidents that cause injury to the brain or spinal cord

• Genetic nerve problems

• Heavy metal poisoning

• Birth defects that affect the spinal cord

• Brain or spinal cord tumors

• Stroke

• Herniated disks

• Multiple sclerosis

• Parkinson disease

What are the symptoms of neurogenic bladder?

These are the most common symptoms of neurogenic bladder:

• Urinary tract infection (UTI)

• Kidney stones

• Unable to control urine (urinary incontinence)

• Small amount of urine when urinating

• Urinary frequency and urgency

• Dribbling urine

• Loss of feeling that the bladder is full

• Unable to urinate

The symptoms of neurogenic bladder may look like other conditions. Always talk with a healthcare provider for a diagnosis.

How is neurogenic bladder diagnosed?

If your healthcare provider thinks you may have neurogenic bladder, they will want to check your brain, spinal cord, and bladder. They will review your health history and do a physical exam. Other tests may include:

• X-rays of the skull and spine. This imaging test uses invisible energy beams to make images of tissues, bones, and organs.

• Imaging tests of the bladder and ureters

• Ultrasound. This imaging test uses sound waves to create images of the organs on a computer screen.

• Cystoscopy. Your healthcare provider puts a thin, flexible tube and viewing device in through the urethra to examine the urinary tract. It checks for structure changes or blockages, such as tumors or stones.

• Tests that are done by filling the bladder, such as urodynamics. These tests show how much the bladder can hold. They also check to see if it fully empties.

How is neurogenic bladder treated?

Treatment for neurogenic bladder depends on the cause. It's aimed at preventing kidney damage and may include:

• Medicines

• Emptying the bladder with a catheter at regular times

• Preventive antibiotics to reduce infection

• A surgical procedure that places an artificial cuff around the neck of the bladder that can be inflated to hold urine and deflated to release it

• Surgical procedures that may enlarge the bladder size or remove a portion of the weak sphincter muscle or create an opening in the belly (stoma) for the urine to drain.

• Botulinum toxin shots (injections) into the bladder muscle. This medicine keeps the bladder from contracting too often.

• Placing an electrical device to stimulate or slow down bladder activity

What are possible complications of a neurogenic bladder?

The following are often linked to a neurogenic bladder:

• Urine leakage. This often happens when the muscles holding urine in don't get the right message.

• Urine retention. This happens if the muscles holding urine in don't get the message that it's time to pass urine.

• Damage to the tiny blood vessels in the kidney. This may happen if the bladder becomes too full and urine backs up into the kidneys. This causes extra pressure. It may lead to blood in the urine and kidney failure.

• Infection of the bladder, ureters, or kidneys. This often results from urine that is held too long before it’s passed out of the body.

Key points about neurogenic bladder

• With neurogenic bladder, the nerves that carry messages back and forth between the bladder and the spinal cord and brain don’t work the way they should.

• Common symptoms include dribbling urine, loss of feeling that the bladder is full, and being unable to control urine (urinary incontinence).

• Damage or changes in the nervous system and infection are some of the causes of neurogenic bladder.

• Treatment is aimed at preventing kidney damage. It may include medicine, urinary catheters, antibiotics to reduce the chance of infection, and in severe cases, surgery.

• Some complications include urine leakage, inability to pass urine, kidney damage, and kidney or urinary tract infections.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours and on weekends and holidays.