What is Neurogenic Bladder

Neurogenic bladder is a bladder control disorder. It is usually caused by problems with the nerves that control the bladder. Your brain sends signals through your spinal cord to the muscles in your bladder that start and stop urine flow.

If you have neurogenic bladder, the nerves and muscles do not work together the way they should.

This condition may make the bladder overactive, meaning you have trouble holding urine. In other cases, it may make the bladder underactive, meaning you have trouble passing urine.

What are the causes?

This condition may be caused by any kind of nerve damage or condition that disrupts the signals from your brain to your bladder. Many things can cause these nerve problems, including:

• A disease that affects the nervous system, such as:
  • Alzheimer disease.
  • Cerebral palsy.
  • Multiple sclerosis.
  • Diabetes.
  • Parkinson disease.
• Damage to your brain or spinal cord. This can come from:
  • Trauma.
  • Tumors.
  • Infection.
  • Surgery.
  • Alcohol abuse.
  • Stroke.
  • A congenital disability that affects the spinal cord.

What increases the risk?

You are more likely to develop this condition if you have nerve damage or a nerve disorder.

What are the signs or symptoms?

Signs and symptoms of this condition include:

• Leaking or gushing urine (incontinence).
• A sudden, strong urge to pass urine (urgency).
• Frequent urination during the day and night.
• Being unable to empty your bladder completely (urinary retention).
• Frequent urinary tract infections.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.
• Results of a bladder diary. You may be asked to keep a record of your bladder symptoms and the times that you urinate.

You may also have tests, such as:

• A urine test to check for infection.
• A bladder scan after you urinate to see how much urine is left in your bladder.
• Tests to measure your urine flow and see how well the flow is controlled (urodynamic tests).
• A procedure that uses a small device with a camera to look through your urethra into your bladder (cystoscopy). A health care provider who specializes in the urinary tract (urologist) may do this test.
• Imaging tests of your brain or spine, such as MRI or CT.

How is this treated?

Treatment for this condition depends on the cause and the symptoms that you have. Work closely with your health care provider to find the treatments that will improve your quality of life. Treatment options include:

• Learning ways to control when you urinate, such as:
  • Urinating at scheduled times.
  • Training yourself to delay urination.
  • Doing exercises to strengthen the muscles that control urine flow (Kegel exercises).
  • Avoiding foods or drinks that make your symptoms worse.
• Taking medicines to:
  • Stimulate an underactive bladder.
  • Relax an overactive bladder.
  • Treat a urinary tract infection.
• Learning how to use a thin tube (catheter) to empty your bladder. A catheter is a hollow tube that you pass through your urethra.
• Procedures to stimulate the nerves that control your bladder.
• Surgery, if other treatments do not help.

Follow these instructions at home:

Lifestyle

• Keep a bladder diary to find out which foods, liquids, or activities make your symptoms worse.
• Use your bladder diary to schedule bathroom trips. If you are away from home, plan to be near a bathroom when your schedule says you will need one.
• Limit your drinking of beverages that stimulate urination. These include soda, coffee, and tea.
• After urinating, wait a few minutes and try again (double voiding).
• Make sure you urinate just before you leave the house and just before you go to bed.

Kegel exercises

Do Kegel exercises to strengthen the muscles that control the passing of urine. These muscles are the ones you use to try to hold urine when you need to urinate. To do Kegel exercises:

1. Squeeze your pelvic floor muscles tight, as if you are trying to stop the flow of urine. You should feel a tight lift in your rectal area. If you are female, you should also feel a tightness in your vaginal area. Keep your stomach, buttocks, and legs relaxed.
2. Hold the muscles tight for 5–10 seconds.
3. Relax your muscles for the same amount of time.
4. Repeat 10 times.

Repeat this exercise 3 times a day or as many times as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You are having a hard time controlling your symptoms.
• Your symptoms are getting worse.
• You have signs of a urinary tract infection. These may include:
  • A burning feeling when you urinate.
  • Chills.
  • Fever.

Get help right away if:

• You cannot pass urine.

Summary

• Neurogenic bladder is a bladder control disorder caused by problems with the nerves that control the bladder. This condition may make the bladder overactive or underactive.
• This condition may be caused by any kind of nerve damage or condition that disrupts the signals from your brain to your bladder.
• Treatment depends on the cause of your neurogenic bladder and the symptoms that you have. Work closely with your health care provider to find the treatments that will improve your quality of life.