What is a “Neurogenic Bladder”?
A neurogenic bladder is the term given to the loss of normal bladder function caused by damage to part of the nervous system. Normal bladder function relies on a complex co-ordination of nerve and muscle function to allow the storage and elimination of urine. Abnormalities of the nervous system can cause problems with
- an underactive bladder – which is unable to contract and empty completely
- an overactive bladder – which contracts too frequently or quickly
- an underactive sphincter (the on/off valve allowing urine storage in the bladder) – which allows urine leakage from the bladder
- an overactive sphincter – which prevents urine from emptying completely.
What conditions can cause a Neurogenic Bladder?
Many conditions can result in abnormal nerve supply to the urinary tract including spinal cord injury which may be congenital (e.g. spina bifida) or acquired (e.g. due to spinal cord trauma or tumour, multiple sclerosis, Parkinson’s disease, strokes and diabetes mellitus).
How is a Neurogenic Bladder diagnosed?
Testing can include imaging of the central nervous system (i.e. brain and spinal cord) as well as testing of the urinary tract. Urinary tract assessment in the case of neurogenic bladder includes tests of kidney function, X-ray imaging of the kidneys and bladder, as well as testing with a urodynamic study. Fluoroscopic urodynamic studies is often crucial to the diagnosis of the type of abnormalities affecting the neurogenic bladder, and determines treatment.
How is a Neurogenic Bladder treated?
Treatment for neurogenic bladder is individualized depending on symptoms and the abnormalities revealed on urodynamic testing. Treatment options include treatments for the overactive bladder such as anticholinergic medications, Botulinum toxin injections into the bladder, and other bladder surgery. If poor bladder emptying is present, clean intermittent catheterisation techniques are used.
Does a Neurogenic Bladder require follow-up?
Close monitoring of the urinary tract is required in all patients with a neurogenic bladder as silent deterioration can occur in bladder function which can risk long-term damage to the bladder and kidneys.