The most common conditions are Alzheimer's disease; birth defects of the spinal cord; brain or spinal cord tumors; cerebral palsy; encephalitis; multiple sclerosis; Parkinson's disease; and spinal cord injury.
Sacral neuromodulation: This technique is used for patients with an overactive bladder when drugs or lifestyle changes do not work. The sacral nerves carry signals between your spine and bladder. Manipulation of these signals can improve overactive bladder symptoms.
In neurogenic bladder, the nerves that carry messages back-and-forth between the bladder and the spinal cord and brain don't work the way they should. Damage or changes in the nervous system and infection can cause neurogenic bladder. Treatment is aimed at preventing kidney damage.
A variety of neurological diseases and disorders, including multiple sclerosis, Parkinson's disease, spinal cord injury, stroke, spina bifida, and hydrocephalus (abnormal accumulation of fluid in the brain) can cause problems with bladder control.
Urinary symptoms can arise due to neurological disease in the brain, the suprasacral spinal cord, the sacral spinal cord (the conus medullaris) or the peripheral nervous system.
Brainstem. The brainstem is located at the base of the skull. Within the brainstem is the pons, a specialized area that serves as a major relay center between the brain and the bladder (see the image below). The pons is responsible for coordinating the activities of the urinary sphincters and the bladder.
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.
Neurogenic bladder treatment involves a variety of experts. We work hand in hand with neurologists, physical medicine and rehabilitation doctors, and other specialists as needed to ensure every aspect of your care is integrated.
Bladder dysfunction, which occurs in at least 80 percent of people with MS, happens when MS lesions block or delay transmission of nerve signals in areas of the central nervous system (CNS) that control the bladder and urinary sphincters.
Up to 85% of people with MS report urinary symptoms related to neurogenic bladder dysfunction at some point during their disease course. Patients can experience a variety of symptoms. The specific symptoms and their severity vary between patients and can evolve over time.
It is widely accepted that neurogenic lower urinary tract dysfunction, when left untreated, has a natural history that has a potential for causing deterioration of renal function over time. However, certain patient profiles are at risk for this and other complications.
Neurogenic bladder refers to a condition in which the bladder isn't empty correctly due to neurological conditions or spinal cord injury. A birth defect, most commonly one that affects the spinal cord, can cause this condition. While neurogenic bladder can't be cured, it is treatable.
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.
Stress, anxiety, and depression may actually contribute to OAB and urinary incontinence. In a study involving more than 16,000 women in Norway, having anxiety or depression symptoms at baseline was associated with a 1.5- to two-fold increase in the risk of developing urinary incontinence.
If nerves that control the bladder or bowel become damaged, it can result in urinary or fecal incontinence. Conditions that may cause this include herniated discs, spinal cord injuries, and cauda equina syndrome.
In people with neurogenic bladder, the nerves and muscles don't work together very well. As a result, the bladder may not fill or empty correctly. With overactive bladder (OAB), muscles may be overactive and squeeze more often than normal and before the bladder is full with urine.
Bladder Nerves in the Sacral Spine
Below the first lumbar vertebrae in the low back, the spinal cord divides into a bundle of nerves called the cauda equina (Latin term meaning tail of a horse).
Neurologic patients often suffer micturition deficits following strokes, tumors, or other focal brain lesions. Collectively, these are referred to as “lower urinary tract symptoms” (LUTS) and include OAB, urgency, nocturia, and urinary incontinence.
There are also cases in which urge incontinence is related to traumatic events. In such cases behavioural and psychotherapeutic options may be helpful. Almost inevitably every form of incontinence has psychological consequences: shame and insecurity are often results of uncontrolled loss of urine.
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).
Many people with MS experience a range of bladder problems, including urinary incontinence. Urinary incontinence may range from occasional leaks when coughing or sneezing to sudden urges to urinate throughout the day, sometimes leaking before making it to the bathroom.