Neurogenic bladder is the term to describe a lack of bladder control due to a brain, spinal cord or nerve problem. The condition affects millions of Americans and often occurs in people who have had a stroke or who have Parkinson’s disease, multiple sclerosis (MS), a brain or spinal cord injury or infection, spina bifida or other conditions.
Neurogenic bladder can present in various ways. The result may be overactive bladder (OAB), underactive bladder (UAB) or incontinence (link). Some people have both overactive and underactive bladder.
- Overactive bladder occurs when the muscles tell the body to urinate more often than normal. Symptoms often include the urge to urinate more frequently and before the bladder is full. If the muscles are weakened, overactive bladder may also result in incontinence or involuntary urination before a person is ready. This could mean leaking or complete voiding.
- Underactive bladder occurs when the bladder muscles do not squeeze the bladder enough to completely empty it or sometimes not empty at all. This can cause the bladder to distend or stretch. It can also decrease nerve sensation. Symptoms include being unable to know when the bladder is full, inability to urinate, painful full bladder and inability to empty all urine from the bladder.
Untreated, neurogenic can cause other complications including skin problems, urinary tract infections or kidney damage.
As previously mentioned, certain health conditions can interfere with proper functioning of nerve messages that must travel between the brain and the muscles that control the bladder.
The most common causes of neurogenic bladder are nervous system disorders, including:
- Alzheimer’s disease
- Brain or spinal cord tumors
- Birth defects of the spinal cord
- Cerebral palsy
- Learning disabilities, such as attention deficit hyperactivity disorder (ADHD)
- Multiple sclerosis (MS)
- Parkinson’s disease
- Spinal cord damage or spinal surgery
Other causes include disorders or damage of the nerves that control the bladder, such as:
- Accidents or trauma
- Congenital (present at birth) abnormalities of the spine
- Diseases such as syphilis, herpes zoster, diabetes and polio
- Erectile dysfunction
- Heavy metal poisoning
- Herniated disc or stenosis of the spinal canal
- General neuropathy
- Long-term, heavy alcohol use
- Some pelvic surgeries
- Tumors of the central nervous system
- Vitamin B12 deficiency
Diagnosis and Treatment
To diagnose neurogenic bladder, it’s best to consult a urologist who specializes in the diagnosis and treatment of urological conditions.
The doctor will perform a physical exam and review a patient’s medical history. There are also several tests that may be ordered to help accurately diagnose the problem. These tests may include:
- Bladder diary
- Ultrasound imaging
- Urodynamic studies
- Other imaging such as X-ray, CT or MRI
Treatments for neurogenic bladder can range from symptom management and behavioral actions to medication to surgery. The treatment a doctor recommends will depend on the cause, the symptoms and the severity of a person’s neurogenic bladder.
Non-surgical treatment options may include medications, behavioral techniques or a urinary catheter.
In some cases, surgical treatment may be required. These treatments can include bladder augmentation, implantation of an electrical device to stimulate the muscles, sling surgery, urinary diversion, sphincter resection or removal, or installation of an artificial sphincter.
Schedule an Appointment
At Alliance Urology Specialists, our goal is to provide the highest level of specialized urology care. Our board-certified urologists with advanced training offer medical and surgical treatment options for those affected by neurogenic bladder. To schedule an appointment, call Alliance Urology Specialists in Greensboro at (336) 274-1114.