Neurogenic Bladder

Definition of Neurogenic Bladder

When neurological conditions affect the bladder, it is called neurogenic bladder.

There are two major types of bladder control problems that are associated with a neurogenic bladder. Depending on the nerves involved and nature of the damage, the bladder becomes either overactive (spastic or hyper-reflexive) or underactive (flaccid or hypotonic).

Symptoms of Neurogenic Bladder

The most common symptom of neurogenic bladder is being unable to control urination. Other symptoms include:

  • A weak or dribbling urinary stream
  • Frequent urination (urinating eight or more times daily)
  • Urgency (a feeling or need to urinate immediately)
  • Painful urination, which may mean there is a urinary tract infection

Causes of Neurogenic Bladder

Neurogenic bladder can be congenital (present at birth).

  • Spina bifida (myelomeningocele): this occurs when the fetal spine does not completely develop during the first month of pregnancy. Babies born with myelomeningocele often have paralysis or weakness that affects how the bladder works.
  • Cerebral palsy: a group of chronic disorders that weaken a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of the brain. The problem causing cerebral palsy may occur while the infant is still in the womb or after birth. Cerebral palsy is not always found during a child’s first year of life.

Various neurologic conditions can cause neurogenic bladder, including the following:

  • Stroke
  • Parkinson’s Disease
  • Alzheimer’s Disease
  • Multiple Sclerosis
  • Spinal cord injury
  • Central nervous system tumors

Treatment Options for Neurogenic Bladder

Clean intermittent catheterization (CIC): catheters are thin, flexible tubes that can be inserted through the urethra and into the bladder to drain urine.

Medication: including anticholinergic medications (oxybutynin, tolterodine) and injections of botulinum A toxin (Botox®) into the bladder or urinary sphincters.

Interstim: Implantation of a bladder pacemaker that helps the bladder relax and store urine more effectively.

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