What is a Neurogenic Bladder?

May 17 2016

Most of us take the healthy functioning of our bladder for granted, but impairment of bladder function can be a deeply troubling cause of daily anxiety if you have a Neurogenic Bladder.  

In this post, we shall look at the symptoms and available treatments for managing the Neurogenic Bladder.

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What is a Neurogenic Bladder?

Conditions of the nervous system that impact the normal functioning of the bladder are referred to as “Neurogenic Bladder”. There are several causes of a Neurogenic Bladder; Spinal Cord Injury (SCI), Multiple Sclerosis (MS), a stroke, Spina Bifida, Parkinson’s disease and lower abdominal surgery to name a few, and all of these conditions share a disruption to the nervous system, which in turn can affect the function of the bladder. Generally speaking, the bladder function impact relates to either under or over activity.

Flaccid Bladder (underactive bladder) 
The  bladder is unable to contract and empty, leading to a full bladder, often accompanied with constant dribbling of urine which may in turn lead to a Urinary Tract Infection (UTI). A common treatment for this condition is Clean Intermittent Catheterization (CIC).

Using a catheter to empty the bladder, as often as one would with a functioning bladder, is an easily learned habit that restores peace of mind and returns control of urination to the user. It’s also discrete, painless and doesn’t require any unwieldly apparatus (a disposable catheter can fit in the pocket), enabling the user to work, travel and enjoy a life unencumbered by anxiety surrounding unrination. Click here for testimonials from CIC users.

Spastic bladder (overactive bladder)
Someone with a spastic bladder will experience uncontrolled spasms of the bladder, forcing urine out. This is called “urge incontinence” or Overactive Bladder. As the bladder contractions and urinary sphincter (the muscle we squeeze to halt urine flow) are often uncoordinated in someone who has a spastic bladder, involuntary urination may occur. Other symptoms include a constant feeling of needing to pee despite having recent urination, pain in the abdomen, and involuntary voiding of large volumes of urine, or regular dribbling.

Managing this condition is crucial to restoring peace of mind, confidence and the enjoyment of life on a moment to moment basis without having to worry about involuntary urination.

Treatments for Neurogenic Bladder

There are several strategies to manage a Neurogenic Bladder, and they are decided based on your age, overall health and medical history, the cause of the nerve damage, the type and severity of symptoms, and your tolerance for certain drugs, procedures or therapies. 

Underactive bladder Overactive bladder

Drugs

Drugs

Lifestyle

  • Schedule voiding

  • Double voiding

  • Bladder diary

  • Dietary changes

Lifestyle

  • Schedule voiding

  • Delayed voiding

  • Pelvic floor exercises

  • Bladder diary

  • Dietary changes

Catheterization

  • Clean intermittent catheters

  • Continous catheters

Neuromodulation

  • Sacral neuromodulation

  • Percutaneous tibial nerve

Surgery

  • Artificial sphincter

  • Urinary diversion

  • Bladder augumentation 

  • Sphincter resection/sphincterotomy

 From Urology Care Foundation, The Official Foundation of the American Urological Association  http://www.urologyhealth.org 

A new development has been the injection of Botox into the bladder walls to inhibit the nerve activity that cause spasms of the bladder. This treatment type has been mentioned in several scientific articles lately: 

“Clinical trials investigating BoNT‑A for the treatment of interstitial cystitis/bladder pain syndrome have shown promising therapeutic effects in reducing bladder pain, repeat injections provide therapeutic effects of a longer duration”
(Jiang, Y.-H. et al. Nat. Rev. Urol. 12, 519–533 (2015); published online 11 August 2015; corrected online 18 August 2015; doi:10.1038/nrurol.2015.193)

The therapy has been largely successful in trials conducted upon patients with an SCI or LUTD (see reference below), and the results indicate that this is a safe intervention, though UTIs caused by large volumes of urine gathering in the bladder have been reported, which can be managed with catheterization, so consultation with a urologist is essential in deciding whether this treatment is suitable.

Read more about CIC

 

Topics: Clean Intermittent Catheterization (CIC), Neurogenic bladder