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 ("UTIs")

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:

●Urine test

●Blood test

●Bladder function tests – For these tests, the doctor puts a thin tube (called a "catheter") into your urethra and fills your bladder with fluid. They measure how much your bladder can hold. You then release the fluid so that the doctor can see if your bladder can empty all of 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 make yourself go every hour, even if you don't feel like you need to. You try to wait until a whole hour has passed if you need to go sooner. Then, once you get used to going every hour, you increase the amount of time you wait between bathroom visits. Over time, you might be able to "retrain" your bladder to wait 3 or 4 hours between bathroom visits.

●Pelvic floor muscle training – This involves learning exercises to strengthen and relax your pelvic muscles. These include the muscles that control the flow of urine and bowel movements. 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 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 cases, a permanent catheter is needed.

If your problems are more serious and medicine and a catheter do not help 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 floor muscle exercises (The Basics)
Patient education: Bladder spasm (The Basics)

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