Several muscles and nerves must work together for our bodies to function. From our heartbeats and breaths to sleep cycles and trips to the bathroom, we rely on the constant communication between our brains and bodies. These neural messages even work together for your bladder to function at its best and are responsible for producing the urge or need to urinate. This is done in a way that gives you enough time to find a bathroom, empty your bladder, and move on with your day. In a healthy urinary system, individuals feel the need to urinate, and the process begins. But sometimes, the communication between the body and brain can be disrupted, resulting in something called a neurogenic bladder. Here, we'll cover what it is and how to manage a neurogenic bladder so you can lead a healthy, fulfilling life.
Understanding Neurogenic Bladder
Neurogenic bladder, sometimes called neurogenic lower urinary tract dysfunction, is caused by a neurological disorder or damage to the nerves that control bladder function. These nerves are responsible for signaling when to store urine and when to empty it. When these nerves are damaged or disrupted, they don't communicate as effectively, which can result in a loss of bladder control.
What Causes Neurogenic Bladder?
Neurogenic bladder can result from several different neurological conditions or injuries, including:
- Spinal cord injury: Damage to the spinal cord can interfere with how nerve messages go back and forth between the brain and the muscles. This, in turn, hinders communication between the nervous system and the bladder, resulting in different bladder control problems or symptoms.
- Multiple sclerosis: This autoimmune disease affects the central nervous system, including the nerves that control the bladder. People who have multiple sclerosis could have underactive bladders (where the bladder overfills), overactive bladders (where the urge to urinate is triggered with less bladder capacity), or a combined bladder dysfunction of the two.
- Spina bifida: This is a congenital condition where the spinal column doesn't close properly, which can result in nerve damage that affects bladder control. Spina bifida can range in severity, which often correlates with the severity of the bladder problems.
- Stroke: Having a stroke can cause injury to brain cells. If individuals aren't treated quickly, this can result in varying degrees of brain damage. In some cases, neurogenic bladder may develop from the brain damage caused by a stroke.
- Parkinson's disease: This is a progressive neurological disorder that can affect various bodily functions, including bladder control. Most commonly, individuals with Parkinson's disease experience urinary incontinence and nocturia as symptoms of neurogenic bladder.
Symptoms of Neurogenic Bladder
The most common neurogenic bladder symptoms
- Urinary incontinence (involuntary leakage of urine)
- Difficulty initiating urination
- Incomplete emptying of the bladder
- Frequent urination
- Urgency to urinate
- Nocturia (frequent urination during the night)
- Hesitation in starting the urine stream
- Weak or dribbling urine stream
- Urinary retention (inability to empty the bladder completely)
- Recurrent urinary tract infections (UTIs)
- Overflow incontinence (leakage of urine when the bladder is full)
Symptoms of neurogenic bladder may also vary depending on the severity of the injury or the underlying cause of the condition, so it's important to work with your doctor to help improve bladder health.
12 Tips to Manage Neurogenic Bladder and Live a Fulfilling Life
Although it can be frustrating, there are several ways to treat neurogenic bladder and minimize the risk of accidents. Always talk to your doctor about managing your symptoms according to your circumstances. To help you get some ideas, here are some of the most common lifestyle changes and neurogenic bladder treatment options available.
1. Use Scheduled Voiding
One strategy to help you with neurogenic bladder management is to try something called scheduled voiding. This involves maintaining a consistent schedule for emptying your bladder several times during the day. Adhering to a routine can train your bladder to empty at specific times throughout the day, reducing the risk of accidents. Your doctor can help you create a personalized voiding schedule that aligns with your lifestyle.
2. Try Delayed Voiding and Double Voiding
People with neurogenic bladder can also try experimenting with delayed voiding and double voiding. Delayed voiding involves intentionally waiting a short period before urinating after you feel the urge, while double voiding involves making a second attempt to empty the bladder shortly after the initial try. Delayed voiding can help train your bladder to hold urine for increasingly longer periods, while double voiding helps empty all of the urine from your body and reduce the risk of UTIs.
3. Avoid Certain Supplements
Some supplements or medications can affect how the bladder works, so it's important to disclose everything to your doctor. This can help you identify and avoid anything that may worsen neurogenic bladder dysfunction symptoms.
4. Limit Foods That Irritate the Bladder
The bladder becomes irritated with certain foods and beverages, which can increase the severity and frequency of symptoms. Try to pay attention to your diet and take note of what causes problems. Some bladder irritants include caffeine, spicy foods, and acidic fruits. Drinks that can irritate the bladder include sugary sports drinks, caffeinated beverages, or carbonated "fizzy" drinks. Alcohol is also an irritant, and some people experience issues with acidic fruit juices.
5. Manage Fluid Intake
In addition to watching what kind of fluid you drink, you should also manage how much. Although it's important to stay hydrated, excessive fluid intake, especially close to bedtime, may contribute to nocturia and disrupt your sleep. Finding a balance between hydration and symptom management is crucial for individuals with neurogenic bladder.
6. Perform Pelvic Floor Exercises
Part of your treatment plan may also incorporate pelvic floor exercises, which help strengthen muscles that support a healthy bladder. Pelvic floor exercises like Kegels can enhance pelvic muscle tone, improve urinary control, and reduce the risk of incontinence episodes.
7. Strengthen Your Bladder Muscles
In addition to pelvic floor exercises, work with your doctor to improve muscle coordination through timed and delayed voiding. This can increase the amount of liquid your bladder can hold, reducing the risk of accidents.
8. Take Doctor-Prescribed Medications
Sometimes, the best treatment for neurogenic bladder includes taking doctor-prescribed medication. Certain medications, such as oxybutynin, tolterodine, mirabegron, solifenacin succinate, and more, may be recommended to regulate bladder function and reduce symptoms. Communicating openly with your healthcare team about any side effects or concerns is essential, allowing for adjustments to the medication plan as needed for optimal symptom management.
9. Consider Botox Injections
Botox injections can also help manage symptoms. Although commonly used for cosmetic purposes, Botox can be injected directly into the bladder muscle to help relax it, thus reducing urgency and incontinence. You'll need to work with a urologist and schedule regular visits, as the Botox will wear off every few months.
10. Utilize Clean Intermittent Catheterization
Clean intermittent self-catheterization may be recommended for individuals with difficulty emptying the bladder. This involves periodically emptying the bladder by inserting a catheter into the urethra at home, allowing the bladder to drain, and removing the catheter. Your doctor may also recommend continuous catheterization, which involves leaving the catheter in place for a certain period. Work closely with your healthcare team to determine the most suitable catheterization approach for your needs.
11. Try Nerve Stimulation Therapy
Sacral neuromodulation (SNS) involves implanting a device near the sacral nerves to help regulate bladder function. Percutaneous tibial nerve stimulation (PTNS) uses electrical stimulation of the tibial nerve. These therapies can help regulate spinal cord or nerve signals and improve bladder control, providing additional options for individuals seeking non-pharmacological interventions.
12. Talk to Your Doctor About Surgery
In some cases, surgical interventions may be considered to address neurogenic bladder symptoms that don't respond to other treatments. Options such as bladder augmentation, urinary diversion surgery, urethral sphincter procedures, or sphincter resection may be discussed with your healthcare provider. Surgical interventions are typically considered when other approaches have not provided relief, and the decision should be made with your medical team based on your unique circumstances and preferences. If you struggle to find management options that work, it's worth discussing your surgical options.
Neurogenic bladder can be managed with some patience and the right supplies. To help, Byram Healthcare provides various urology resources and support as needed. We’re also proud to offer high-quality urologic products that can be discreetly delivered to your home at any time of the day. Visit our educational support page or our product selection guide to learn more.
