Neurogenic Bladder

Overview

 

Problems with urinating - such as difficulty going, going frequently or losing control - can have many causes. One possible cause is something called neurogenic bladder, a condition in which patients have difficulty urinating normally because of a problem with the nervous system (brain, spinal cord and nerves).

 

Your ability to hold urine and empty your bladder at the right time depends on the proper workings of the entire nervous system. If there is damage, your muscles may not tighten or relax properly, meaning you may have one or both potential signs of neurogenic bladder:

  • An overactive bladder. Symptoms would include:
    • Urinating frequently (8 or more times a day or more than twice at night)
    • Having sudden urges to urinate
    • Losing bladder control (leaking urine before you get to the bathroom)
  • An underactive bladder. Symptoms would include:
    • Having trouble starting to urinate
    • Not sensing that the bladder is full and needs to be emptied
    • Dribbling urine rather than having it flow smoothly

Neurogenic bladder can be present at birth, especially for those with birth defects such as spina bifida or cerebral palsy.

 

It also can develop later in life, if you are diagnosed with a nervous system disorder such as: 

  • Parkinson's Disease
  • Stroke
  • Spinal cord injury
  • Alzheimer's Disease
  • Cerebral Palsy
  • Multiple sclerosis

Diagnosis and Tests

 

Your doctor will begin by reviewing your history and performing a physical exam. If there is reason to suspect neurogenic bladder, your doctor may suggest one or more of these diagnostic tests: 

  • Urodynamics. This is a test that evaluates your bladder’s ability to store and release urine.
  • A cystoscopy, which allows your doctor to see the lining of your bladder and the urethra (the tube that carries urine out of your body)
  • Imaging (CT, MRI or X-ray), allowing the doctor to see your spine, brain, kidneys or bladder

Management and Treatment

 

If you are diagnosed with neurogenic bladder, your doctor may recommend one or more treatments. These include:

  • Medications are available to help relax the bladder or stimulate the nerves to help increase urinary flow
  • Botulinum Toxin (Botox®) can be injected into the bladder muscle itself to calm overactivity and allow for better storage of urine.
  • Catheterization. In some cases, having a thin tube inserted into your bladder can better help you get rid of all the stored urine.
  • Surgery. Some patients may require surgery to increase the bladder capacity (bladder augmentation) or create alternate routes for emptying (urinary diversion). 

How UW Health Can Help

 

Patients may contact the UW Health Urology Clinic by calling (608) 263-4757 or 1-800-323-8942.

 

Your physician is welcome to contact UW Health Urologist Sarah McAchran, MD, or any provider from the UW Health Urology team to help answer any questions. We can be reached at 1-800-472-0111 or (608) 263-3260.

 

Resources

 

Other good sources of information include: