The causes of an underactive bladder are divided into 3 categories: Neurogenic – related to abnormalities of the nerve supply of the bladder. Myogenic – due to a problem with the muscle of the bladder also known as the
Neurogenic Bladder, also known as Neurogenic Lower Urinary Tract Dysfunction, is when a person lacks bladder control due to brain, spinal cord or nerve problems.
A reflex neurogenic bladder can be thought of as the result of a complete upper motor neuron lesion. Detrusor sphincter dyssynergia would be common with this type of neurogenic bladder. Autonomous neurogenic bladder represents a complete disruption of both motor and sensory nervous system control over the bladder.
Diane Newman, adult nurse practitioner and a continence nurse specialist in urology outlines four types of neurogenic bladder disorders: atonic bladder, hyper-reflexive bladder, uninhibited bladder, and sensorimotor paralytic bladder.
The life expectancy of patients in the VS ranges from 3 to 5 years [6].
The most common symptom of neurogenic bladder is being unable to control urination. Other neurogenic bladder symptoms include: A weak or dribbling urinary stream. Frequent urination (urinating eight or more times daily).
Medicine for Neurogenic Bladder
Your health care provider may suggest: Overactive bladder medicines that relax the bladder such as oxybutynin, tolterodine, or solifenacin, as well as mirabegron. Bladder muscle injections to relax the bladder, such as injection of Botulinum toxin.
This nerve damage can be the result of diseases such as multiple sclerosis (MS), Parkinson's disease or diabetes. It can also be caused by infection of the brain or spinal cord, heavy metal poisoning, stroke, spinal cord injury, or major pelvic surgery.
When assessing neurogenic bladder, a panel of lab tests including urinalysis, urine culture, serum blood urea nitrogen (BUN) and creatinine, and creatinine clearance are ordered.
Neurogenic bladder—following radical pelvic surgery
Following radical pelvic surgery is characterized by DU, poor sensation to filling, and coordinated or fixed-tone sphincter. Clinically these patients present with urinary retention or UTIs. It is not thought to be progressive.
It usually results from brain damage or spinal cord damage above T12. Precise symptoms vary by site and severity of the lesion. Bladder contraction and external urinary sphincter relaxation are typically uncoordinated (detrusor-sphincter dyssynergia).
It is important to treat neurogenic bladder to prevent kidney damage due to urinary problems. If neurogenic bladder goes untreated, a patient might develop renal disease. People with renal disease may require dialysis or a kidney transplant.
Also called neurogenic bladder, this can result from spinal injuries, neurological disorders and congenital malformations. Neurogenic bladder requires treatment from urologists who specialize in neurourology.
The second theory is that anxiety and stress can cause muscle tension, which can affect the muscles of the bladder and increase the urge to urinate. Anxiety and depression are also associated with nocturia, which is the term for frequently waking during sleep to go to the bathroom.
A urologist or urogynecologist can diagnose and treat neurogenic bladder. The symptoms of neurogenic bladder may resemble those of other conditions and medical problems.
Left untreated, neurogenic bladder can cause severe, even life-threatening, kidney damage. Fortunately, many effective options are available to help with both medical and quality-of-life concerns.
A neurogenic bladder disability is rated according to the level of voiding dysfunction. 38 C.F.R. § 4.115b, Diagnostic Code 7542. Voiding dysfunction is to be rated as urine leakage, frequency, or obstructed voiding.
Brain Magnetic Resonance Imaging (MRI) Identifying brain areas involved in changes in bladder volume and urgency to void affecting brain activity might help to understand brain mechanisms that control urinary continence and micturition.
Other long-term complications include nephrolithiasis, refractory urinary incontinence, and malignancy.
While neurogenic bladder can't be cured, necessarily, it can most definitely be managed. Most cases of neurogenic bladder can be managed with medication and intermittent catheterization. The minority of children with the condition need major reconstructive surgery.