Neurogenic bladder dysfunction happens when the nerves in the spinal cord that control the bladder don’t work correctly.
Often neurogenic bladder is the result of a spinal cord injury or a central nervous system disease like spina bifida, Parkinson’s disease, multiple sclerosis or even diabetes. It can sometimes be the result of an infection in the brain or spinal cord, or even result from major pelvic surgery. Sometimes strokes can cause neurogenic bladder.
Symptoms of Neurogenic Bladder
Symptoms of neurogenic bladder depend on the kind of nerve damage that’s causing the problem. Sometimes the bladder can become overactive, or it may become underactive. Some patients get both of those symptoms.
Recurring urinary tract infections can often be the first symptom of neurogenic bladder. When the bladder becomes overactive, urine can leak and patients become incontinent. You can also feel sudden urges to urinate that you just can’t ignore. Sometimes overactive bladder causes people to urinate many more times than normal, during the day or at night. (If you urinate more than 8 times in 24 hours, you may have ooveractive bladder.) Neurogenic bladder can also cause the bladder to become underactive, making it more difficult to empty the bladder fully.
How Neurogenic Bladder is Diagnosed
To diagnose neurogenic bladder, in addition to a physical exam you may be asked to keep a bladder diary to track your symptoms. Tests like a urine culture, bladder scan via ultrasound, or cystoscopy may be required. Urodynamic testing can also be done to determine how well your bladder stores and releases urine. X-rays and CT scans may also be required for proper diagnosis.
Treatment of Neurogenic Bladder
There are many successful treatments for neurogenic bladder. These can include lifestyle changes like scheduled voiding and dietary changes. Physical therapy and pelvic floor exercises can also help, along with neuromodulation therapy. There are many drugs that can treat neurogenic bladder, including Botox injections as well as oral medications. Sometimes patients must be taught to catheterize their bladder for relief, and in some cases surgical interventions can provide the best treatment.
Neuromodulation