Neurogenic (NU-ro-JEN-ik) bladder is a disorder affecting the nerve supply to the urinary bladder in which the person loses control of bladder function.
There are three types of neurogenic bladder.
Neurogenic bladder is caused by disorders of the central nervous system * , or the parts of the central nervous system that supply the urinary bladder, including:
Damage to the nerves that supply the bladder can cause neurogenic bladder. Such damage can be related to surgery in the pelvic area, the area containing the bladder and the organs of the female reproductive system. Other disorders that can cause neurogenic bladder related to damage of the nerves supplying the bladder include:
Signs or symptoms of neurogenic bladder are related to the cause of the problem and often include urinary incontinence, or inability to control bladder function. Signs may be related to overactive bladder or underactive bladder and include:
Men may report signs of erectile dysfunction * .
The healthcare provider takes a complete health history including asking questions about urinary bladder function and the specific causes of neurogenic bladder, for example, asking whether the person has diabetes. A laboratory examination of the urine is done to determine if there is any infection that is causing the problem. An ultrasound * * may also be ordered to determine cause of the problem. The healthcare provider may refer the affected individual to a specialist called a urologist, which is a physician who has specialized knowledge and experience in the treatment of diseases and conditions of the urinary and renal system (kidneys, bladder, ureters, and urethra).
Additionally, a thorough review of all medications being taken is important because some medications may have a side effect of urinary incontinence associated with neurogenic bladder. Changing the medication may resolve the problem.
Treatment of neurogenic bladder is generally focused on the cause of the problem. For example, if the person has diabetes, keeping the diabetes under control through diet, exercise, and medication may help relieve problems with neurogenic bladder. Additionally, medications may be prescribed that relax the bladder or that improve the function of nerves innervating the bladder. Exercises that strengthen the muscles of the pelvic floor, called Kegel (KEE-gel) exercises, may be taught.
Medications which may be prescribed to treat urogenic bladder in some cases include estrogen therapy, which is used to help increase the muscle tone of the urethra; anticholinergic drugs to inhibit involuntary contraction of the bladder; antispasmodic drugs to relax bladder muscles; and tricyclic antidepressant medications, which are useful in promoting bladder muscle relaxation.
The person will also be asked to keep a bladder diary (or log) noting when they urinate, how much they urinate, if they have had urinary leakage accidents, and if there are any other symptoms of urinary problems, such as painful urination, difficulty starting to urinate, bad odor of urine, and blood in the urine. A bladder training program may be recommended. Bladder training programs include instruction in Kegel exercises, keeping a bladder diary, scheduling specific times to empty the bladder, and strategies to improve and maintain bladder function.
In some cases, for example in spinal cord injury, the person may need to use a urinary catheter, a thin tube inserted into the bladder, to empty the bladder.
Surgery may be required to treat neurogenic bladder. Types of surgery include creating an artificial urinary sphincter (the muscle that controls the flow of urine from the bladder), implanting an electrical device that stimulates the bladder muscles, or creating an opening, called a stoma, to divert urine from the bladder to a pouch outside the body (urinary diversion).
People with neurogenic bladder are encouraged to maintain adequate fluid intake. Some people think that if they decrease their fluid intake, the problem will be resolved; however, it is important to maintain adequate fluid intake to promote normal function of the kidneys, bladder, and urinary system.
Although many causes of neurogenic bladder cannot be prevented, there are some things that have been linked to urinary incontinence that can be managd.
Strategies to Prevent Neurogenic Bladder include:
See also Alzheimer's Disease • Cerebral Palsy • Diabetes • Incontinence • Multiple Sclerosis (MS) • Nocturia • Overactive Bladder • Parkinson's Disease • Sexually Transmitted Infections (STIs): Overview • Slipped (Herniated) Disk • Urinary Tract Infections
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Merck Manual, Consumer Version. “Neurogenic Bladder.” http://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/disorders-of-urination/neurogenic-bladder (accessed March 31, 2016).
Womenshealth.gov . “Urinary Incontinence Fact Sheet.” http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html (accessed March 31, 2016).
National Institute on Aging. Building 31, Room 5C27, 31 Center Dr., MSC 2292, Bethesda, MD 20892. Toll-free: 800-222-2225. Website: https://www.nia.nih.gov/ (accessed March 31, 2016).
National Institute of Diabetes and Digestive and Kidney Diseases. Bethesda, MD 20892-2560. Telephone: 301-496-3583. http://www.niddk.nih.gov (accessed May 12, 2016).
The Simon Foundation for Continence. PO Box 815, Wilmette, IL 60091. Toll-free: 800-237-4666. Website: www.simonfoundation.org (accessed March 31, 2016).
Voices for PFD (Pelvic Floor Disease). 2025 M Street NW, Suite 800, Washington, DC 20036. Telephone: 202-367-1167. Website: www.voicesforpfd.org (accessed March 31, 2016).
* central nervous system (SEN-trul NER-vus SIS-tem) is the part of the nervous system that includes the brain and spinal cord.
* erectile dysfunction (e-REK-tile dis-FUNK-shun) is a condition in which a man is unable to maintain a penile erection sufficient for satisfying sexual activity.
* ultrasound is a diagnostic test in which sound waves passing through the body create images on a computer screen. Also called a sonogram.
* CT scan computed tomography (to-MOG-ra-fee) scans, or CAT (computerized axial tomography) scan, uses computers to view structures inside the body.