What Is Neurogenic Bladder?

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If you have been experiencing trouble with bladder control, then you are dealing with a situation that can be stressful to live with. But you should know that there are options and approaches that can help you improve your control over your urination.

There are several different types of bladder control problems. One of these is called neurogenic bladder, which means that the cause of your urination problems is related to the nerves that control your bladder.

Symptoms of Neurogenic Bladder

The symptoms of neurogenic bladder include a variety of urination problems, some of which may actually seem to be at odds with one another. Often, neurogenic bladder results in involuntary urination as well as the inability to voluntarily urinate. Many people with neurogenic bladder experience a combination of these problems.

Neurogenic bladder can manifest as minor or severe urinary incontinence (loss of bladder control) as well as mild or extreme urinary retention (the inability to release urine). Common symptoms of neurogenic bladder include any combination of the following:

  • Feeling the urge to urinate frequently
  • Releasing only small amounts of urine each time you go to the toilet
  • Leaking of urine without noticing it
  • Leaking of urine without the ability to stop it
  • The sudden urge to urinate, with little or no warning
  • Unable to start the stream of urine
  • Unable to completely empty the bladder
  • Unusual, uncomfortable or painful sensations in the lower abdominal area

Effects of Neurogenic Bladder

Incontinence and urinary retention can both cause a variety of problems and often unpleasant consequences:

Effects of incontinence (urinary leaking):

  • Wetting clothes
  • Unpleasant odor from urine leaks
  • Skin irritation from urine leaks
  • Sores on the skin that may be painful and can become infected
  • Unpredictability of urinary urges
  • Embarrassment due to leaking small or large amounts of urine when around other people

Effects of urinary retention (bladder retention):

  • Physical discomfort
  • Abdominal pain or pressure
  • Urinary tract infection—this results from urine remaining in the bladder for too long, which can allow infectious bacteria to thrive. A urinary tract infection often requires treatment with prescription strength medications.

Diagnosis of Neurogenic Bladder

Your doctor can diagnose neurogenic bladder based primarily on your history of symptoms. Sometimes, a urine analysis or further testing of your bladder function may be needed.

There are other causes of incontinence and urinary retention besides neurogenic bladder, so you may have another cause of your symptoms besides neurogenic bladder that would need to be treated depending on what it might be. This is why it is important to talk to your doctor and get the right diagnosis for the most effective treatment.

Treatment of Neurogenic Bladder

There are several effective treatments for neurogenic bladder. Medical and surgical management of neurogenic bladder is complicated and often requires a team of doctors and therapists.

Sometimes, you may need a combination of different treatments or you might need to have your medication or therapy adjusted as you are getting started on the treatment. The different therapies for neurogenic bladder include:

  • Treatment of the underlying cause of neurogenic bladder (multiple sclerosis, neuropathy, etc.)
  • Medications to control the bladder muscles. Some of the different types of medications include: Estrogen therapy, Imipramine, Amitriptyline, Oxybutynin, Tolterodine, Fesoterodine, Trospium, Darifenacin, Solifenacin, Mirabegron. These medications act on the nerves or muscles to help you regain some control of the urination process.
  • Surgical treatment involves placement of nerve stimulators or devices to help optimize nerve and muscle function in neurogenic bladder.
  • Injections of medication can be administered directly into the muscles that control the bladder in certain situations of neurogenic bladder.
  • Bladder training through physical therapy or occupational therapy
  • Using a catheter to empty the bladder: A catheter is a straw-like tube than can be inserted into the bladder to allow the urine to flow. This method is only useful under certain circumstances of urinary retention, and you would be given instructions from a health care professional until you feel ready to use this method on your own.
  • Lifestyle modification can help you cope with the symptoms, but it cannot cure the problems. Lifestyle modifications include wearing a pad or diaper, urinating on a schedule to avoid surprises, and avoiding drinks and medications that are either dehydrating or that have a diuretic effect (promoting excess fluid loss from the body).

Causes of Neurogenic Bladder

There are several causes of neurogenic bladder. These are generally serious neurological conditions that produce several different symptoms besides neurogenic bladder. These conditions do not always cause neurogenic bladder, because they may or may not involve the nerves associated with bladder control. The most common of causes of neurogenic bladder include:

The way that these conditions cause neurogenic bladder is by interfering with the function of the nerves that control the bladder. The bladder itself is a muscular sac that holds the body's fluid waste after it gets filtered in the kidneys.

Normally, the bladder holds a reasonable amount of urine until it is convenient to urinate, and then the bladder muscle voluntarily squeezes to release urine from the body (this is urination). There are nerves that 'activate' the bladder muscles to start, stop or hold in the urine, depending on the situation and upon your intentions.

Neurogenic bladder occurs when the nerves that control voluntary urination and/or voluntary 'holding it in' are not able to maintain this control of holding in the urine or releasing the urine at the most convenient time.

A Word From Verywell

Neurogenic bladder can be an inconvenient result of several medical conditions. In addition to the embarrassment and discomfort associated with a lack of bladder control, neurogenic bladder can also cause additional health problems, such as infections and sores.

There are effective ways to manage neurogenic bladder so that you can lead a productive life with as little interference of your bladder dysfunction as possible. Your medical team can direct you to the best resources to manage your life with neurogenic bladder.

Since you may need some lifestyle adjustments as well as medical therapy, it is important to maintain contact with your medical team and to follow up closely so that you can benefit from the best treatment plan available for you.

Sources:

Potential Future Pharmacological Treatment of Bladder Dysfunction, Andersson KE, Basic Clin Pharmacol Toxicol. 2016 Oct;119 Suppl 3:75-8

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