When conditions or abnormalities of the nervous system such as stroke, Parkinson’s disease, spinal cord injury and multiple sclerosis, as well as congenital birth defects such as spina bifida, adversely affect normal bladder function, the condition is called neurogenic bladder. Neurogenic bladder is a complex bladder disorder.
People with nerve damage typically have little or no sense of when the bladder is full and often cannot control when urine is released from the bladder. For patients with spinal cord injury, for example, the signals from the bladder letting the brain know the bladder is full do not work. Thus, signals from the brain that let the bladder know it’s time to empty also don’t work.
Fortunately, Urology Associates has some of the South Eastern’s foremost physicians specializing in neurogenic bladder, fellowship-trained in neuro-urology and diagnosing and treating this complex condition.
Types of Neurogenic Bladder
- Overactive Bladder: patients have little or no control urinating, resulting in urinary incontinence and urine leakage. Individuals often experience a sudden urge to urinate or find they are urinating more frequently.
- Underactive Bladder/Urinary Retention: the bladder loses the ability to empty properly, resulting in a buildup of urine that causes pressure in the bladder and subsequent urine leakage. Patients typically cannot completely empty their bladders.
What Causes Neurogenic Bladder?
Multiple disorders, particularly conditions that affect the nervous system, can cause neurogenic bladder, including:
- Parkinson’s disease
- Multiple sclerosis
- Spinal cord injuries
- Spinal surgeries
- Central nervous system tumors
- Traumatic brain injuries
- Spinal congenital birth defects such as spina bifida
Diagnosis and Treatment of Neurogenic Bladder?
The key to treatment is to determine the type of neurogenic bladder – besides a thorough history and exam, bladder nerve testing (UroDynamics), radiological studies (ultrasound or CT), and cystoscopy.
Treatment can be medication, behavior modification, or surgery. Consultation with a neurologist or neurosurgeon may also be beneficial.
Symptoms of Neurogenic Bladder
The symptoms are based on the type of bladder nerve that is damaged.
- Sensory Nerves: Gives the feeling of a full or empty bladder and the urge to urinate
- Motor Nerves (both bladder and sphincter): The ability to hold urine and to be able to urinate
- Mixed Senory and Motor: The most common type
Urinary incontinence, or the involuntary leakage of urine, as well as urinary retention and overflow incontinence (with possible leaking), are the most common symptoms of neurogenic bladder. Other symptoms can include:
- Frequent urination (usually small amounts)
- Frequent urine leakage, but the individual cannot sense this
- Urinary urgency (with or without incontinence)
- Weak urine stream
- Difficulty or straining to urinate (with inability to empty)