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Neurogenic Bladder

Damage to the nervous system may sometimes cause patients to lose normal bladder function, a condition known as neurogenic bladder. Under normal conditions, the nervous system controls bladder function by sending messages from the brain to the bladder and from the bladder to the brain that signal a tightening or release of the bladder during urination. Patients suffering from this condition may experience an underactive bladder unable to contract or empty completely or an overactive bladder that contracts too quickly and frequently.

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Common Causes/Risk Factors of Neurogenic Bladder

  • Birth defects affecting spinal cord and bladder function (i.e. – spina bifida)
  • Traumatic spinal cord injury
  • Tumors located in the spinal cord or pelvic area
  • Common Symptoms of Neurogenic Bladder include:
  • Urinary incontinence
  • Dribbling urinary stream
  • Inability to urinate
  • Painful urination
  • Frequent/ Urgent urination
  • Vesicoureteral reflux (abnormal urine back-up)
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Diagnosis

In the case of neurogenic bladder, a patient’s nervous system and bladder are tested to determine a diagnosis. The following tests may be utilized by a urologist:

  • Skull and spinal X-rays
  • Electroencephalogram (EEG) of brain function
  • Imaging tests of the bladder and ureters
  • Bladder function tests
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Treatments

Typically, the first line of treatment for neurogenic bladder is antibiotic medication. Patients may also undergo clean intermittent catherization (CIC) to empty a bladder that is unable to contract or a bladder that has lost urinary coordination.

Surgery

Surgical treatments for neurogenic bladder may include:

  • Endoscopic surgery to cut the external urethral sphincter (muscle that controls urine flow from the bladder)
  • Implantation of permanent stents
  • An endoscopic injection of paralytic agents into the external urethral sphincter to provide temporary relief.

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