Neurogenic Bladder Disorders

Neurogenic bladder disorders are caused by an injury or condition that disrupts the nerves that communicate between the bladder and the brain.

Patients with a neurogenic bladder may experience the following symptoms:

• Dribbling urine
• Kidney stones
• Urinary incontinence (inability to control urine)
• Urinary frequency and urgency
• Urinary tract infection (UTI)
• Small urine volume during voiding
• Loss of feeling that the bladder is full
• Urinary retention

Individuals may also experience fecal incontinence and/or constipation.

Left untreated, a neurogenic bladder may lead to the following complications:

• Urine leakage often occurs when the muscles holding urine receive the wrong signal.
• Urine retention occurs if the muscles holding urine don’t get the message that it’s time to pass urine.
• Damage to the tiny blood vessels in the kidney may occur if the bladder is extremely full and urine backs up into the kidneys. This builds up pressure and may lead to blood in the urine.
• Infection of the bladder, ureters, or kidneys may be caused by urine that is held too long before it’s passed out of the body.

The following conditions or events may cause neurogenic bladder disorder:

• Diabetes
• Infections
• Genetic nerve problems
• Heavy metal poisoning
• Brain or spinal cord tumors
• Birth defects that affect the spinal cord
• Accidents that cause injury to the brain or spinal cord

During the initial doctor’s appointment the physician will need to order exams of the brain, spinal cord, and bladder. Other diagnostic tests for a neurogenic bladder may include:

• X-rays of the skull and spine use invisible energy beams to visualize the tissues, bones, and organs.
• Imaging tests of the bladder and ureters.
• Ultrasound (also called sonography) that uses high-frequency sound waves to visualize the organs on a computer screen.
• Cystoscopy, which involves inserting a thin, flexible tube and viewing device through the urethra to examine the urinary tract. The test checks for structure changes or blockages, such as stones or tumors.
• Tests that involve filling the bladder, such as urodynamics, will show how much the bladder can hold and check to see if it fully empties.

Patients diagnosed with neurogenic bladder disorder may begin treatment with intermittent or continuous catheterization to drain the bladder.

Intermittent catheterization involves periodic insertion of a catheter to drain the bladder. This treatment option is for patients who are unable to fully empty their bladder.

Patients suffering from complete incontinence may need to use a continuous catheter connected to a drainage bag. Medication may also be used to provide relief and improve bladder function.

Other treatment options may include:

• Preventative antibiotics to reduce infection
• Placement of an artificial cuff around the neck of the bladder which can be inflated to hold urine and deflated to release it
• Surgery to remove stones or blockages
• Botox injections into the bladder muscle

Patients may also benefit from sacral nerve stimulation, which involves implanting a small device under the skin of the buttocks and surgically connecting it to the nerves that control the bladder. The device will send signals to these nerves to improve the connection between the bladder and brain.