What is Neurogenic Bladder?

Your bladder is a crucial part of the urinary tract system. This balloon-shaped organ stores urine, a waste product created from the kidneys after filtering your blood. Your bladder is controlled by a number of voluntary and involuntary muscles and nerves. When you use the bathroom, your bladder is relaxed. As it begins to fill with urine, the muscles send nerve signals to your brain to let you know that it’s getting full—this creates the feeling you get when you need to use the restroom. When you urinate, your brain tells the muscles in your bladder to contract, which forces the urine out of your body. In a healthy individual, this process works seamlessly from day to day. Unfortunately, the urinary tract system is subject to a number of problems and can affect how you use the bathroom. One of these problems is neurogenic bladder. In this article, we’ll answer the question: what is neurogenic bladder? We’ll also go over some common symptoms, how neurogenic bladder is diagnosed, and what you can do for treatment options.

Understanding Neurogenic Bladder

Your urinary system relies on a series of nerves that send and receive messages from the bladder and the brain and spinal cord. Neurogenic bladder is a condition where the nerves that tell the bladder to contract or release don’t work properly. The messages that are supposed to be sent back-and-forth are interrupted or not sent. The nerve damage can occur as a result of a number of diseases or injury and results in urinary problems.

Causes of Neurogenic Bladder

Neurogenic bladder can occur if you have problems with your nervous system, underdeveloped muscles, or from injuries that are localized in the spine.  Many cases of neurogenic bladder are congenital and caused by birth defects. Some of the most common causes of neurogenic bladder include spina bifida, sacral agenesis, cerebral palsy, and a number of other medical conditions.

Spina Bifida

Spina bifida, or myelomeningocele, is a disorder where a fetus’ spine does not completely develop during the first month of pregnancy.¹ Babies who are born with spina bifida have either slight or major paralysis in some form or weakness in the nerves along the spine that affect how your bladder and urinary tract system works.

Sacral Agenesis

This condition occurs when you’re missing the sacrum—the lowest portion of the spine that forms the joint with the hips. It’s a congenital condition and is fairly rare. Due to the missing spinal cord region, nerve signals can get lost going to the bladder.

Cerebral Palsy

Cerebral palsy is a group of chronic disorders that weakens your ability to control body movement and posture.¹ Cerebral palsy can occur during fetal development and is a result from injury to the motor areas of the brain.¹ Due to a child’s developmental stages, cerebral palsy isn’t always found immediately.

Various Medical Conditions

In addition to the primary, congenital causes, various other medical conditions can lead to neurogenic bladder. Some of them include:¹

• Stroke
• Parkinson’s disease
• Multiple sclerosis
• Spinal cord injuries
• Spinal surgeries
• Erectile dysfunction
• Trauma/accidents
• Central nervous system tumors
• Heavy metal poisoning
• Encephalitis
• Vaginal childbirth
• Diabetes

Common Symptoms of Neurogenic Bladder

Symptoms of neurogenic bladder can vary from person to person and mirror many other common urologic problems. Certain symptoms depend on the type and severity of nerve damage. Some people have symptoms of overactive bladder while others present symptoms of underactive bladder, but it’s possible to have symptoms of both. The most common symptom of neurogenic bladder is being unable to control urination.¹ Other symptoms include the following:

• Urinary tract infections
• Overactive bladder
• Frequent urination
• Urgency
• Urinary incontinence
• Urinary retention
• Underactive bladder
• Kidney stones
• Dribbling urine
• Loss of feeling that your bladder is full

If you have any symptoms of neurogenic bladder, or any other concerns regarding your urinary health, see your doctor immediately. Urinary problems can lead to a decrease in quality life, but there are options for treatment once properly diagnosed.

When left untreated, neurogenic bladder can lead to damage to the blood vessels in the kidney. This is due to the extra pressure that happens if a bladder becomes too full and nerve signals aren’t telling you that it’s time to use the restroom. Neurogenic bladder symptoms can also result in infection of the bladder, ureters, or kidneys so it’s important to get the proper treatment and monitor yourself for any symptoms.

How Urologists Diagnose Neurogenic Bladder

If you think you might have neurogenic bladder, call your urologist. There are a number of diagnostic tests that can be done to make sure that your nervous system and bladder are healthy.

Medical History

At the beginning of your visit, your doctor will go over your medical history with you. This includes understanding your symptoms and how they’re affecting your daily life. Be honest with past conditions, medication use, and diet. If you smoke or drink heavily, tell your doctor upfront. All of these can have an impact on your urinary tract system, so it’s important to get the big picture.

Physical Exam

Next, you’ll go through a normal physical exam to help determine what’s causing your symptoms. This is a regular physical and will give your doctor an understanding of your overall health.

Bladder Diary

While this test is not done at the doctor’s office, it’s helpful in determining the cause of your urologic symptoms. Your doctor will have you keep a bladder diary and record how often you go to the bathroom and any time that you leak urine throughout the day.

Pad Test

A pad test involves wearing a pad that’s been treated with a special dye. If you leak urine, the pad changes color so it can be tracked. This is done to better understand your symptoms and the intensity to which they’re occurring.

Urine Culture

A urine culture is a common urological test that will allow your doctor to examine your urine and test it for any signs of infection or traces of blood. The color of your urine will also be noted to help better understand your problem.

Bladder Scan

Your doctor may also give you a bladder scan. They will have you use the bathroom, then use a special kind of ultrasound to look at your bladder and see how much urine is still in your bladder. It allows doctors to understand the strength of your voiding.

Cystoscopy

A cystoscopy uses a tiny camera to get a better picture of what’s going on. Your doctor will insert the device, which is a narrow tube with a small lens on the front, into your bladder to check if anything else could be causing your symptoms.

Urodynamic Testing

A series of different urodynamic tests will be performed to determine how well your lower urinary tract system works and how efficient it is as releasing urine. Talk to your doctor about urodynamic testing to better understand what specific tests you’ll need.

If need be, your doctor may also perform different x-rays or a CT scan to diagnose your condition. You may also be referred to a specialist to get a better picture of your spinal cord and brain functioning.

Neurogenic Bladder Treatment

If you’ve been diagnosed with neurogenic bladder, don’t worry. There are plenty of treatment options to help you improve your quality of life. Your doctor will begin with lifestyle changes to see if you can get symptoms under control. If things are still severe, medications, catheterization, or surgery may be required.

• Lifestyle Changes – many people find success in scheduled voiding, delayed voiding, keeping a bladder diary, and making changes to your daily habits. It’s important to avoid bladder irritating foods and quit smoking.
• Medications – certain medications can help you relax or contract your bladder muscles to gain control of voiding. There are oral medication options and even gels or patches to help. Some people have found success with botulinum toxin injections, but you need to work with your urologist to ensure the medications aren’t having any negative effects.
• Catheters – clean intermittent catheterization can help you empty your bladder if you cannot control your muscles for urination.
• Surgery – in more serious cases of neurogenic bladder, surgery may be required. Talk to your doctor about urinary diversion surgery, bladder augmentation, sphincter resection, or getting an artificial sphincter.

Conclusion

Maintaining a healthy bladder is important, but sometimes things go wrong. If you notice any signs of neurogenic bladder or have a child with a congenital condition that could result in neurogenic bladder, contact your urologist. When choosing your supplies to help improve life with neurogenic bladder, Byram Healthcare can help.

1 https://my.clevelandclinic.org/health/diseases/15133-neurogenic-bladder