Neurogenic Bladder

Illustration of the anatomy of the urinary system, front view

What is a neurogenic bladder?

The muscles and nerves of the urinary system work together to hold urine in the bladder and then release it at the appropriate time. Nerves carry messages from the bladder to the spinal cord and brain and from the collections of nerves in the peripheral nervous system to the muscles of the bladder telling them either to tighten or release. In a neurogenic bladder, the nerves that are supposed to carry these messages do not work properly.

What are the complications of a neurogenic bladder?

The following problems are often associated with a neurogenic bladder:

  • Urine leakage. Urine leakage often occurs when the muscles holding urine in do not get the right message.

  • Urine retention. Urine retention often happens if the muscles holding urine in do not get the message that it is time to let go.

  • Damage to the tiny blood vessels in the kidney. Damage to the tiny blood vessels in the kidney often happens if the bladder becomes too full and urine backs up into the kidneys, causing extra pressure. This can result in blood in the urine.

  • Infection of the bladder or ureters. Infection of the bladder or ureters often results from urine that is held too long before being eliminated.

What causes neurogenic bladder?

The following are possible causes of neurogenic bladder:

  • Diabetes

  • Acute infections

  • Accidents that cause trauma to the brain or spinal cord

  • Genetic nerve problems

  • Heavy metal poisoning

What are the symptoms of neurogenic bladder?

The following are the most common symptoms of neurogenic bladder. However, each individual may experience symptoms differently. Symptoms may include:

  • Urinary tract infection

  • Kidney stones (These may be difficult to determine because you may not be able to feel pain associated with kidney stones if you have spinal cord abnormalities.) Symptoms of kidney stones include:

    • Chills

    • Shivering

    • Fever

  • Urinary incontinence

  • Small urine volume during voiding

  • Urinary frequency and urgency

  • Dribbling urine

  • Loss of sensation of bladder fullness

The symptoms of neurogenic bladder may resemble other conditions and medical problems. Always consult your physician for a diagnosis.

How is neurogenic bladder diagnosed?

When neurogenic bladder is suspected, both the nervous system (including the brain) and the bladder itself are examined. In addition to a complete medical history and physical examination, diagnostic procedures for neurogenic bladder may include the following:

  • X-rays of the skull and spine. This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Electroencephalogram (EEG). This procedure records the brain's continuous, electrical activity by means of electrodes attached to the scalp.

  • Imaging tests of the bladder and ureters.

  • Tests that involve filling the bladder. These tests show how much the bladder can hold and check to see if the bladder empties completely.

What is the treatment for neurogenic bladder?

Specific treatment for neurogenic bladder will be determined by your physician based on:

  • Your age, overall health, and medical history

  • Severity of symptoms

  • Cause of the nerve damage

  • Type of voiding dysfunction

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Treatment may include:

  • Insertion of a catheter or hollow tube (to empty the bladder at regular intervals)

  • Prophylactic (preventive) antibiotic therapy (to reduce the incidence of infection)

  • Placement of an artificial sphincter (A procedure that involves placing an artificial cuff around the neck of the bladder that can be inflated to prevent urinary incontinence and deflated when it is time to empty the bladder. You will still require intermittent catheterization to completely empty the bladder.)

  • Surgery