Neurogenic Bladder
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What is neurogenic bladder?
Neurogenic bladder (NGB) is a term used for dysfunctional voiding, or voiding problems, due to a neurologic condition or injury. The symptoms of NGB are wide-ranging including urinary incontinence, urinary retention (incomplete voiding or inability to void), pelvic pain, urinary tract infections, and possible deterioration of kidney function.
NGB may result from injury or insult to any level of the spinal cord, brain or nerves that innervate the bladder that lead the bladder not to function properly. The diseases are many, including brain tumors, cerebral palsy, strokes, dementia, Parkinson’s Disease, Multiple Sclerosis, Polio, Trauma, Diabetes, to name a few.
How is neurogenic bladder diagnosed?
At UCLA Urology we are fully equipped to evaluate patients with bladder and urination issues. Patients may require urodynamics, cystoscopy, and renal ultrasound or CAT scans to evaluate the kidneys.
What is the treatment for neurogenic bladder?
The treatment for NGB is wide-ranging and individualized. Some patients may be treated conservatively ranging from medical management and intermittent foley catheterization to surgery requiring bladder augmentation or creation of a continent catheterizable stoma.
Nonsurgical Treatments:
- Medications such as anticholinergics may be used to treat NBG. Anticholinergics work to relax the bladder muscle and prevent urinary leakage.
- Botox (onabotulinumtoxinA) is a neurotoxin that is injected into the bladder muscle. This acts to treat overactive bladder symptoms such as urinary frequency, urgency and urgency incontinence by relaxing the bladder muscle. More about Botox >
Surgical Treatments:
- Sacral nerve stimulation (SNS) is a procedure that is FDA approved for the treatment of NGB. It is a device where wires are placed near the sacral nerves that innervate the bladder. A battery is placed under the skin and connected to the wires if the device is effective.
- Surgery is performed to expand the bladder capacity in a patient with NGB when all other treatments have failed. An augmentation cystoplasty may be performed where a piece of bowel is used to expand the bladder capacity. Another procedure that may be performed is a continent catheterizable stoma where a piece of bowel is used to expand the bladder capacity and a portion of that bowel may be tunneled towards the skin so urine may drain through the abdominal wall. These procedures are tailored to patients’ individual needs.
