Condition: Neurogenic bladder means bladder problems that are caused by brain or nerves conditions such as stroke, brain injury and spinal cord injuries and disorders.
Background: Neurogenic bladder causes people to lose control of urination. The type of problem a person has depends on where the damage is in the brain or nervous system.
Risk Factors: In addition to the conditions listed above, other diseases of the brain or spinal cord such as infections, cancer, and multiple sclerosis can all cause neurogenic bladder. It can also be caused by other diseases that cause nerve damage, such as diabetes and dementia.
History and Symptoms: Symptoms include not being able to stop the flow of urine (incontinence), feeling the urge or straining to urinate, or not completely emptying the bladder. There may also be a history of urinary tract infections (UTIs).
Physical Exam: A muscle and neve exam will be completed to help diagnose one of the conditions above. In addition physical medicine and rehabilitation (PM&R) physicians, also known as physiatrists, will test sensations and reflexes in the muscles around the lower abdomen and pelvis; this could include a rectal exam. Tests of thinking and memory may also be done.
Diagnostic Process: Tests of blood and urine are done to look for infections or problems with the kidneys. Ultrasound imaging of the bladder and kidneys may also be done. Other tests can be used to study pressure in the urinary tract and electrical activity in the muscles and nerves that control urination.
Rehab Management: The goals of treatment are to maintain control over urination and prevent kidney and bladder complications, including urinary tract infections. PM&R physicians are experts at determining the type of neurogenic bladder. Specific drugs may either relax the bladder muscles or help them contract, depending on the type of neurological damage to the bladder. Behavior changes such as going to the toilet on a regular schedule and drinking less at certain times of day may also help. Exercises can help strengthen muscles involved in urination. Sometimes surgery or catheters are needed.
Other Resources for Patients and Families: Family support can help patients stick to their treatment plan. WebMD provides a nice resource for further information.