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Neurogenic bladder is a problem with how the bladder works. It may empty too often or at the wrong time. This is called incontinence. The bladder may also not be able to fully empty all of the urine. The urine may then build up and move back up into the kidney.
Poor flow of urine can lead to infections and kidney damage. Treatment can decrease the risk of these problems.
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Nerves control the action of the bladder. Signals move from the bladder to the brain, and the brain to the bladder. Neurogenic bladder is a problem with any part of this process. It may be the result of:
Factors that increase your chance of neurogenic bladder include:
Symptoms of neurogenic bladder may include:
You will be asked about your symptoms and past health. An exam will be done. You may be asked to keep a diary. Keep track of how often you drain your bladder, feel urges, and any waking at night to pass urine. The doctor may need tests to rule out other possible causes.
Tests may include:
Problems with the structure of the urinary tract can cause symptoms. Images of the kidneys, ureters, and bladder can be taken with:
To see how well the bladder is working, you may also have:
The goal of treatment is to empty your bladder on a routine basis. This should help to ease symptoms. The right plan will depend on your specific needs.
Treatment options include:
Early steps may include:
A thin tube can be placed into the bladder. It will allow urine to leave the bladder. You can learn to do this yourself or your care team may do it for you.
Medicines that may be considered include:
Surgery may be an option for severe cases. It may be considered when all other treatments fail. Surgery options include:
The bladder can send wrong signals to the brain. PTNS can override signals from the bladder and decrease symptoms.
A small needle electrode is inserted at the ankle. Small electrical impulses are passed through the needle to nearby tibial nerve. The impulses travel up to nerves in the pelvis that control the bladder. The new impulses block incorrect bladder signals to the brain.
Most cases of neurogenic bladder cannot be prevented. People with diabetes may be able to delay or avoid the problem with good control of blood sugar levels.
National Association for Continence
Urology Care Foundation
Canadian/American Spinal Research Organizations
Bladder control problems & nerve disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-nerve-disease. Updated June 2012. Accessed December 11, 2018.
Neurogenic bladder. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/15133-neurogenic-bladder. Updated May 10, 2016. Accessed December 11, 2018.
Neurogenic bladder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900602/Neurogenic-bladder. Updated October 18, 2018. Accessed December 11, 2018.
Neurogenic bladder. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/kidney_and_urinary_system_disorders/neurogenic_bladder_85,p01487. Accessed December 11, 2018.
Neurogenic bladder. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/neurogenic-bladder?article=9. Accessed December 11, 2018.
7/28/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116944/Benign-prostatic-hyperplasia-BPH: Mangera A, Apostolidis A, Andersson KE, et al. An updated systematic review and statistical comparison of standardised mean outcomes for the use of botulinum toxin in the management of lower urinary tract disorders. Eur Urol. 2014;65(5):981-990.
Last reviewed November 2018 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 12/11/2018