Your bladder relies on muscles to contract and release when you are ready to urinate. Your brain typically regulates this process, but sometimes the message that you need to urinate is not sent from your brain to your bladder. This is a condition known as neurogenic bladder. Treatment for this condition can help you regain control over urination.
Neurogenic bladder results in the loss of control over your ability to urinate. This can cause you to urinate too much or not enough, both of which can have harmful consequences.
Neurogenic bladder symptoms include:
- a dribbling stream when urinating
- the inability to fully empty your bladder
- straining during urination
- loss of bladder control
- increased urinary tract infections
- leaking urine
- difficulty determining when your bladder is full
If you experience these or other symptoms related to your bladder, see your physician.
Neurogenic bladder is a condition caused by the nerves along the pathway between the bladder and the brain not working properly. This can be due to a brain disorder or bladder nerve damage.
Examples of brain disorders that cause neurogenic bladder include:
- Alzheimer’s disease
- tumors on the brain or spinal cord
- multiple sclerosis
- Parkinson’s disease
- injury to the spinal cord
- spinal cord birth defects, such as spina bifida
Conditions that affect the bladder muscles include:
- nerve damage from diabetes or long-term alcohol abuse
- nerve damage during pelvic surgery
- spinal nerve damage
If your physician suspects you have a neurogenic bladder, he or she will test your bladder muscles and your nervous system. By treating the underlying condition, your symptoms may lessen.
A neurogenic bladder causes you to lose control over the sensation to urinate. This can cause your bladder to stretch and fill beyond typical capacity until it suddenly empties itself.
A neurogenic bladder, and the urinary retention that often comes with it, increase your risk of urinary tract infection. Infection can result when your urine remains too long in the bladder or kidneys.
Frequent urinary tract and kidney infections can lead to kidney damage over time. This can ultimately lead to kidney failure.
Your physician may recommend a variety of diagnostic tests to diagnose neurogenic bladder.
In addition to your medical history and a physical exam, your doctor may order the following tests:
- a cystometrogram (to test bladder function and capacity)
- an electromyography (to test bladder muscle tone and coordination)
- spinal and brain imaging
- kidney and bladder imaging
The results of the testing will help your physician make a diagnosis.
Your physician will likely recommend a variety of treatments to combat a neurogenic bladder. He or she may suggest that you urinate at regular intervals, which prevents the bladder from becoming too full at any point in time. Therapies such as Kegel exercises and muscle strengthening may help your neurogenic bladder.
Your physician may ask you to keep a journal to record any leakage incidents to determine the appropriate intervals for you to urinate.
Another treatment option is electrical stimulation therapy. This therapy involves placing small electrodes on the bladder. When stimulated, the electrodes can send impulses to the brain, telling it you need to urinate.
There are no medications to specifically treat or control neurogenic bladder. However, some medications can reduce or enhance muscle contractions. These help to ensure proper emptying of the urinary tract.
Low-dose antibiotics also may help minimize risk for urinary tract infections. In some instances, your physician may recommend catheterization to ensure complete bladder emptying. This painless process involves inserting a thin plastic tube into the bladder to release urine. However, this procedure carries a risk for increased urinary tract infections.
Your physician may want you to have an artificial sphincter inserted in your body that works to stimulate urination. Other surgical options include implanting a urethral stent, which mimics the action of a catheter.
Medical manufacturers are continuing to release new inventions, such as bladder slings, to reduce symptoms and help improve bladder control. Your doctor will take these into consideration when helping you determine what’s best for you.
Whatever the treatment method, your physician will work to minimize kidney damage that can occur. This can help to prevent eventual kidney failure, a condition that can be fatal.