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.
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:
Nerve or spinal cord conditions 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:
Dribbling urine stream
Straining while passing urine
Not being able to pass enough urine (urinary retention)
Overflow of urine from a full bladder
Passing urine is painful
Urinary tract infections that keep coming back
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:
Urinalysis—to look for signs of infection or kidney changes
Blood tests—to look for signs of infection
Problems with the structure of the urinary tract can cause symptoms. Images of the kidneys, ureters, and bladder can be taken with:
Surgery may be an option for severe cases. It may be considered when all other treatments fail. Surgery options include:
Remove part of the muscle that holds the bladder closed (men only)—urine then flows out into a tube attached to the penis.
Create an opening in the belly and connect urinary tract to it. This will allow urine to pass out of the body and into an attached bag.
Make the bladder larger with tissue from the bowel.
Replace the bladder. A new pouch is made from areas of the bowel or other tissue.
Insert a stent. This small tube can help to prop open the bladder neck. It will allow urine to flow more freely.
Urethral sling (women only)—device is placed to help lift the urethra. It will slow flow of urine and stop leakage.
Sacral neuromodulation—a device is placed into the pelvis. It can deliver impulses to the nerves that send signals from bladder to brain. It can reduce the number of signals telling the bladder to contract.
Percutaneous Tibial Nerve Stimulation (PTNS)
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.
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. 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.
Last reviewed November 2018 by
EBSCO Medical Review Board
Adrienne Carmack, MD
Last Updated: 12/11/2018
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