Your bladder relies on muscles to contract and release when you’re ready to urinate. Your brain typically regulates this process, but sometimes the message that you need to urinate isn’t sent from your brain to your bladder. This is a condition known as neurogenic bladder. Treatment for this condition can help you regain control.
Neurogenic bladder causes you to lose 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
- an inability to fully empty your bladder
- straining during urination
- a loss of bladder control
- increased urinary tract infections (UTIs)
- leaking urine
- difficulty determining when your bladder is full
See your doctor if you have these symptoms or others that are related to urinating.
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 can cause neurogenic bladder include:
- Alzheimer’s disease
- tumors of 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:
- diabetes, which can cause nerve damage
- long-term alcohol abuse
- pelvic surgery, which can cause nerve damage
- spinal nerve damage
If your doctor thinks you might have a neurogenic bladder, they’ll test your bladder muscles and your nervous system. Treating the underlying condition can help your symptoms.
Because this condition causes you to lose the sensation to urinate, your bladder can fill beyond typical capacity and leak. But your bladder may not empty fully. This is called urinary retention.
Urinary retention increases your risk of a UTI. Infection can result when urine remains in your bladder or kidneys for too long.
Frequent urinary tract and kidney infections can lead to damage over time. This can ultimately lead to kidney failure, which can be fatal.
In addition to reviewing your medical history and conducting a physical exam, your doctor may recommend a variety of diagnostic tests to determine if you have neurogenic bladder. These may include:
- 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
Your doctor will likely recommend a variety of treatments.
They may suggest that you urinate at regular intervals, which will prevent your bladder from becoming too full. Your doctor may also ask you to keep a journal to record any leakage incidents. This can help you determine the best intervals for urinating. They may also suggest therapies such as Kegel exercises and pelvic floor muscle strengthening.
Electrical stimulation therapy
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 treat or control neurogenic bladder specifically. However, some medications can reduce or enhance muscle contractions. These help to ensure proper emptying of the urinary tract.
In some instances, your doctor 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 the risk for increased UTIs. Your doctor may prescribe antibiotics at low doses to minimize the risk for UTIs.
Your doctor can insert an artificial sphincter into your body that compresses the urethra to prevent urinary leakage which can then be manually released to allow emptying of the bladder. Other surgical options include bladder reconstruction surgery which may help with bladder control.
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.