Neurogenic Bladder
Multimedia
Definition
Neurogenic bladder is a problem in which a person lacks bladder control due to a brain or nerve condition.
See also: Urinary incontinence
Causes, incidence, and risk factors
Several muscles and nerves must work together for your bladder to hold urine until you're ready to empty it. Nerve messages go back and forth between the brain and the muscles that control bladder emptying. If these nerves are damaged by illness or injury, the muscles may not be able to tighten or relax at the right time.
Disorders of the central nervous system commonly cause neurogenic bladder. This can include:
Damage or disorders of the nerves that supply the bladder can also cause this condition. This can include:
- Alcoholic neuropathy (nerve damage due to long-term, heavy alcohol use)
- Diabetic neuropathy (nerve damage due to long-term diabetes)
- Nerve damage due to pelvic surgery
- Nerve damage from a herniated disc
References
Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
Review Date: 4/30/2011
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Symptoms
The specific symptoms depend on the cause, and may include:
Symptoms of overactive bladder:
Symptoms of underactive bladder:
Bladder becomes too full and you may leak urine
Problems starting to urinate or emptying all the urine from the bladder
Unable to tell when the bladder is full
Urinary retention
References
Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
Review Date: 4/30/2011
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Treatment
Medications may help manage your symptoms. Your doctor may recommend:
- Medicines that relax the bladder (oxybutynin or propantheline)
- Medicines that make certain nerves more active (bethanechol)
- Botulinum toxin (Botox)
Your doctor may refer you someone who has been trained to help people manage bladder problems. Skills or techniques you may learn include:
- Exercises to strengthen your pelvic floor muscles (Kegel exercises)
- Keeping a diary of when you urinate, the amount, and if you leaked urine. This may help you learn when you should empty your bladder and when it may be best to be near a bathroom.
Learn to recognize the symptoms of urinary infections, such as burning when you urinate, fever, low back pain on one side, and a more frequent need to urinate.
Some people may need to use a urinary catheter. This is a thin tube that is inserted into your bladder:
- You may need a catheter to be in place all the time (indwelling catheter)
- You may need a catheter to be placed in your bladder 4 to 6 times a day to keep your bladder from becoming too full (intermittent catheterization)
Sometimes surgery is needed. Surgeries for neurogenic bladder include:
- Artificial sphincter
- Electrical device implanted near the bladder nerves, to stimulate the bladder muscles
- Sling surgery
- Creation of an opening (stoma) in which urine flows out of the into a special pouch (this is called urinary diversion)
Support Groups
See: Incontinence resources
Complications
- Chronic urine leakage can cause skin breakdown and pressure sores
- Kidney damage may occur if the bladder becomes too full, causing pressure to build up in the tubes leading to the kidneys and in the kidneys themselves
- Urinary tract infections
Calling your health care provider
Call you health care provider if you:
- Are unable to empty your bladder at all
- Have signs of a bladder infection (fever, burning when you urinate, frequent urination)
- Urinate small amounts, frequently
References
Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
Review Date: 4/30/2011
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
References
Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
Review Date: 4/30/2011
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 4/30/2011
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.