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Patient education: Neurogenic bladder in adults (The Basics)

Patient education: Neurogenic bladder in adults (The Basics)

What is neurogenic bladder? — Neurogenic bladder is a condition that causes problems with bladder control (figure 1). This most often happens in people who have a spinal cord injury. Other conditions that affect the brain or spinal cord, such as multiple sclerosis or a stroke, can also cause neurogenic bladder.

What are the symptoms of neurogenic bladder? — People with this condition might:

Urinate small amounts more often than usual

Have problems starting to urinate or emptying their bladder

Lose bladder control

Have problems knowing if their bladder is full

Have repeated urinary tract infections

Are there tests for neurogenic bladder? — Yes. Your doctor or nurse will ask about your symptoms and do an exam. They might also ask you to keep a diary of your urinary habits, such as how often you empty your bladder.

For other tests, your doctor will likely refer you to another doctor who specializes in bladder problems, such as a urologist or gynecologist. Tests you might need include:

A urine test

A blood test

Bladder function tests – For these tests, the doctor puts a thin tube (called a "catheter") into your urethra and fills you bladder with fluid. They measure how much your bladder can hold. You will then release the fluid so the doctor can see if your bladder can empty all the way.

Imaging tests – These tests create pictures of the inside of the body. They can include X-rays, an ultrasound, a CT scan, and an MRI.

Is there anything I can do on my own to feel better? — Yes. These methods might help you to better control your bladder:

Bladder retraining – To do this, you go to the bathroom at scheduled times. For instance, you might decide that you will go every hour. You would make yourself go every hour, even if you didn't feel like you needed to. And you would try to wait until a whole hour had passed if you needed to go sooner. Then, once you got used to going every hour, you would increase the amount of time you waited in between bathroom visits. Over time, you might be able to "retrain" your bladder to wait 3 or 4 hours between bathroom visits.

Pelvic muscle exercises – These exercises strengthen the muscles that control the flow of urine. These exercises can help, but people often do them wrong. Ask your doctor or nurse how to do them right.

Should I see a doctor or nurse? — See your doctor or nurse right away if:

You have new loss of bladder control, especially if you also have back pain or leg weakness.

You have neurogenic bladder and get symptoms of a urinary tract infection (also called a "UTI"), which include:

Pain or a burning feeling when you urinate

The need to urinate often

The need to urinate right away or in a hurry

Blood in the urine

Fever

How is neurogenic bladder treated? — Treatments include:

Prescription medicines – Some of these medicines relax the bladder, such as oxybutynin (brand name: Ditropan) or propantheline (brand name: Pro-Banthine). Others can make certain nerves more active, such as bethanechol (brand name Urecholine). You might also need antibiotics if you get a UTI.

Bladder catheter – If you cannot empty your bladder completely, you might need to put a thin, flexible tube (called a "catheter") in your urethra a few times a day. The catheter helps you empty your bladder and avoid infection and other problems. In rare case, a permanent catheter is needed.

If your problems are more serious and medicine and a catheter are not helpful enough, you might need other treatments to control your bladder. These can include nerve stimulators, botulinum toxin (Botox) injections, and surgery.

More on this topic

Patient education: Urinary incontinence in females (The Basics)
Patient education: Pelvic muscle (Kegel) exercises (The Basics)

Patient education: Urinary incontinence in women (Beyond the Basics)
Patient education: Urinary incontinence treatments for women (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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