Neurogenic Bladder
Neurogenic bladder is a condition characterized by the loss of bladder function, which prevents people from effectively emptying the bladder. Normal bladder function involves a complex communication system between nerves and muscles that work together to tighten or release the bladder muscles and allow urine to be released. Neurogenic bladder is often the result of problems with nerves in the body that control how the bladder stores or empties urine.
Causes of Neurogenic Bladder
Neurogenic bladder may develop after an accident or trauma to the brain or spinal cord. It can be a common complication of major pelvic surgery. Patients afflicted with the following conditions may also be at a higher risk for developing neurogenic bladder:
- Diabetes
- Cerebral palsy
- Alzheimer's disease
- Multiple sclerosis
Neurogenic bladder may also occur because of a genetic nerve defect, or tumors in the spinal cord or pelvis.
Symptoms of a Neurogenic Bladder
The first sign of a neurogenic bladder may be repeated urinary tract infections. Patients with neurogenic bladder may also experience the following symptoms:
- Urine leakage
- Painful urination
- Urine retention
- Frequent urination
- Incontinence
- Bladder infection
Symptoms may vary for each person depending on which nerves (if any) have been damaged.
Diagnosis of a Neurogenic Bladder
A neurogenic bladder is diagnosed by an examination of both the nervous system and the bladder itself. A physical examination is performed and the patient's medical history is reviewed. The doctor may ask about any neurological problems such as back injury, stroke, or other neurological diseases. The following tests may also be used to diagnose neurogenic bladder:
- Urodynamic studies or bladder function tests
- Cystoscopy
- X-rays
- CT scans
- MRI tests
Patients may also be asked to keep a "bladder diary" to help the physician better understand their day-to-day symptoms. In some cases, patients may be referred to a neurologist for further consultation.
Treatment of a Neurogenic Bladder
Treatment for neurogenic bladder often begins with medication, which can be effective in relieving symptoms of the condition. In addition, the following treatments may be suggested:
- Antibiotics to treat infections
- Kegel exercises to strengthen pelvic muscles
- Botox injections into the bladder
- Catheter to empty the bladder at regular intervals
- Electrical device implanted near the bladder nerves to stimulate the bladder muscles
Severe cases may require surgical implantation of a permanent stent or an artificial sphincter.
Prevention of Neurogenic Bladder
While all cases of neurogenic bladder cannot be prevented, behavioral changes may help in curtailing the severity of symptoms. Recommendations may include:
- Limiting fluid intake to avoid putting stress on the bladder
- Modifying diet to avoid foods and beverages that may irritate the bladder
- Performing kegel exercises to help strengthen the pelvic muscles
Effective management of this condition can help to reduce a patient's risk of recurrence. If symptoms of neurogenic bladder are not treated, they may lead to kidney problems or renal disease.
