Neurogenic bladder is when a person lacks bladder control due to brain, spinal cord, or nerve problems.
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Nerve signals go back and forth between the brain and the muscles that control the bladder. Neurogenic bladder is a problem with this process. It may be the result of:
Things that may raise the risk of neurogenic bladder are:
- Nerve or spinal cord problems present since birth, such as spina bifida or spinal cord tumor
- Other causes of brain injury, such as infection or trauma
Symptoms of neurogenic bladder may include:
- Problems controlling the flow of urine
- Dribbling urine flow
- Straining while passing urine
- Not being able to pass enough urine
- Overflow of urine from a full bladder
- Pain when passing urine
The doctor will ask about symptoms and health history. A physical exam will be done. The doctor may need tests to rule out other possible causes.
Tests may include:
- Urinalysis—to look for signs of infection or kidney changes
- Blood tests—to look for signs of infection
Pictures may be taken of the kidneys, ureters, and bladder. This can be done with:
Tests may also be done to see how well the bladder is working. This can be done with:
- Bladder function tests
- Urodynamics to find out how well urine flows
The goal of treatment is to be able to empty the bladder on a routine basis. This should help to ease symptoms. The right plan will depend on a person's needs.
Treatment options may be:
People with diabetes may be able to lower the risk of neurogenic bladder by managing their condition.
Early steps may include:
- Bladder training—set a schedule to empty the bladder.
- Pelvic floor exercises—to make muscles around the bladder stronger
- Painless electrical stimulation—to help retrain the bladder muscles.
- Ginsberg DA, Boone TB, Cameron AP, Gousse A, Kaufman MR, Keays E, Kennelly MJ, Lemack GE, Rovner ES, Souter LH, Yang CC, Kraus SR. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation. J Urol. 2021 Nov;206(5):1097-1105.
- Neurogenic bladder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/neurogenic-bladder.
- Neurogenic bladder. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/neurogenic-bladder?article=9.
- Romo PGB, Smith CP, Cox A, et al. Non-surgical urologic management of neurogenic bladder after spinal cord injury. World J Urol. 2018 Oct;36(10):1555-1568.
- Mark S. Itzkowitz, MD, JD
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