People with spina bifida often have neurogenic bladder, a condition that occurs due to nerve damage. If you have neurogenic bladder, you can leak urine, retain urine, or both. Treatment is necessary to prevent complications.
Spina bifida (SB) is a condition in which the neural tube, the precursor to the brain and spinal cord, doesn’t close all the way during development. In other words, some bones of the spine don’t close completely around the spinal cord.
Because part of the spinal cord is unprotected, people with SB often have damage to their spinal cord and nerves. The damage can result in several health tissues, including neurogenic bladder.
Neurogenic bladder is a condition in which a person doesn’t have control of their bladder due to nerve damage. This article will cover how neurogenic bladder affects people with SB.
Groups of nerves and muscles work together to store and void urine from your body. When damage affects the nerves upstream of your urinary tract, these nerves and muscles may not work together as well anymore.
In people with SB and neurogenic bladder, the bladder doesn’t fill and empty properly. This is
The detrusor muscle is the bladder muscle that’s relaxed while your bladder is filling and contracts to release urine. The urethral sphincters are muscles that hold urine in your bladder while contracted and allow urine to leave your body when relaxed.
When the bladder is full, your brain sends signals that tell your detrusor muscle to contract and your urethral sphincters to relax, which allows urine to leave the body.
With DSD this function isn’t coordinated. As a result, you could experience retention of urine in the bladder, unexpected release of urine from the bladder, or both.
Some of the potential symptoms that people with neurogenic bladder and SB experience may include:
Neurogenic bladder happens in people with SB because the nerves of the spinal cord haven’t developed properly or have been damaged. The damage or underdevelopment can, in turn, affect bladder control.
While any person with SB can have neurogenic bladder, it’s particularly common in people who have a type of SB called “myelomeningocele.”
Myelomeningocele is the most serious type of SB. People with myelomeningocele have a sac protruding from their spine that contains nerves or parts of the spinal cord that are damaged.
There are several complications that people with SB and neurogenic bladder may experience. These include:
- frequent UTIs, which may develop into a kidney infection
- bladder or kidney stones
- worsening urinary incontinence
- hydronephrosis, a condition in which the kidneys become swollen due to the backup of urine
Over time, the effects of neurogenic bladder can damage the urinary tract. Urinary tract damage can lead to damage to your bladder, kidneys, or both. In severe situations, people with SB and neurogenic bladder can develop kidney failure.
Some of the tests that may be used to help diagnose neurogenic bladder in people with SB are:
- ultrasound of the urinary tract
- urodynamic tests, which are a group of tests that assess the filling and emptying of your bladder
- voiding cystourethrogram, which uses X-rays and a fluorescent dye to allow a doctor to examine the structure of your bladder, how well it functions, and whether urine is backing up into your kidneys
The treatment of neurogenic bladder in people with SB typically begins shortly after birth. The goals of treatment are to promote continence, prevent damage to the urinary tract, and improve quality of life.
Some of the potential treatments for neurogenic bladder include:
- Clean intermittent catheterization (CIC): Clean intermittent catheterization (CIC) involves regularly using a catheter inserted through the urethra and into the bladder to empty the bladder.
- Anticholinergics: Anticholinergics are medications that can help to reduce pressure in the bladder as well as involuntary contractions of the bladder muscle.
- Botox injections: Botox injections can help the bladder muscle relax.
- Surgery: Surgery is typically only used when other treatments haven’t been effective. Examples of surgeries to treat neurogenic bladder include:
- Urinary diversion: Urinary diversion is surgery in which an opening is made in the abdomen that allows urine to pass out of the bladder and into a collection bag outside of the body.
- Bladder Augmentation: Bladder augmentation is surgery that enlarges the bladder by removing part of the intestine and attaching it to the bladder wall.
- Other options: Data also suggests that
transcutaneous electrical nerve stimulationand sacral neuromodulation therapycan help people with SB and neurogenic bladder. These treatments use electrical impulses to stimulate the bladder muscle.
People with SB and neurogenic bladder will need lifelong bladder management. Treatment can differ between individuals based on factors such as:
- the severity of bladder symptoms
- how symptoms respond to treatment
- whether or not complications are present
- your overall health
Individuals with neurogenic bladder will need to have regular health check-ins so that a doctor can assess how the treatment is working and check for any complications.
Continence in people with SB and neurogenic bladder may improve with age. A
How many people in the United States are born with spina bifida?
How common is neurogenic bladder in people with spina bifida?
A 2017 study notes that research estimates of the percentage of people with SB that have bladder or bowel incontinence vary greatly, from
SB is a condition in which the spinal cord and spine don’t develop properly, leading to nerve damage. As such, many people with SB have neurogenic bladder.
Neurogenic bladder is a condition in which your bladder control is affected by nerve damage. People with neurogenic bladder may have bladder incontinence, urine retention, or both.
The management of neurogenic bladder in people with SB is lifelong, and it can involve one or a combination of medications, CIC, and surgery.