neurogenic bladder

What is Neurogenic Bladder?

Neurogenic bladder refers to a group of urinary conditions in individuals who experience bladder control issues due to brain, spinal cord, or nerve problems [3][5]. This condition can result from internal or external trauma, leading to neurologic dysfunction and subsequent bladder malfunction [4].

Common Symptoms

The symptoms of neurogenic bladder include:

• Dribbling urine
• Loss of feeling that the bladder is full
• Inability to control urine (urinary incontinence)
• Overflow incontinence
• Frequency
• Urgency

These symptoms can vary depending on the severity and location of the nerve damage [8].

Causes

Neurogenic bladder is caused by damage or changes to the nervous system, which affects the muscles and nerves that control the bladder. This can result from conditions such as spinal cord injuries, spina bifida, or other brain and spinal cord disorders [1][6].

Types of Neurogenic Bladder Dysfunction

There are two main types of neurogenic bladder dysfunction:

• Flaccid: characterized by a lack of muscle tone in the bladder
• Spastic: characterized by increased muscle tone in the bladder

Both types can lead to urinary control issues and other symptoms [8].

Neurogenic Bladder Symptoms

Neurogenic bladder, also known as neurogenic voiding dysfunction, is a condition where the nerves that control the bladder are damaged or disrupted. This can lead to various symptoms that affect the bladder's ability to store and release urine properly.

Common Signs and Symptoms:

• Loss of bladder control: The inability to control urination, leading to accidents or leakage.
• Weak or dribbling urinary stream: A weak flow of urine or a constant dripping sensation.
• Frequent urination: Needing to urinate too often, even when the bladder is not full.
• Urinary frequency and urgency: Feeling a sudden, urgent need to urinate, even if the bladder is not full.
• Inability to empty the bladder: Problems fully emptying the bladder, leading to incomplete voiding or retention.
• Urinary tract infections (UTIs): Increased risk of UTIs due to incomplete emptying or frequent urination.

Additional Symptoms:

• Feeling tired, depressed, anxious, and lonely due to the emotional impact of incontinence.
• Skin problems or infections caused by leaking urine.
• Inability to fully empty the bowel, leading to constipation or fecal incontinence (neurogenic bowel).

These symptoms can vary from person to person and may be accompanied by other complications. If you're experiencing any of these symptoms, it's essential to consult a healthcare professional for proper diagnosis and treatment.

References:

• [1] Symptoms include loss of bladder control, weak or dribbling urinary stream, frequent urination, and inability to empty the bladder.
• [2] Other neurogenic bladder symptoms include overflow incontinence, frequency, urgency, urge incontinence, and retention.
• [3] Risk of serious complications includes recurrent infection, kidney damage, and other urinary tract problems.
• [4] Symptoms also include having to urinate too often but in small amounts, problems emptying all the urine from the bladder, and loss of bladder control.

Diagnostic Tests for Neurogenic Bladder

Neurogenic bladder, also known as neurogenic voiding dysfunction, is a condition where the nerves that control the bladder and urinary system are damaged or impaired. Diagnosing this condition requires a comprehensive evaluation of the nervous system and the bladder.

Imaging Tests

Several imaging tests can be used to diagnose neurogenic bladder:

• X-rays: X-rays of the skull and spine can help identify any abnormalities in the bones that may be contributing to the condition.
• Ultrasound: An ultrasound test can detect hydronephrosis (swelling of the kidney) and other urinary tract problems.
• Voiding cystourethrogram (VCUG): This is an X-ray exam of the bladder and lower urinary tract that can help identify any blockages or abnormalities in the urinary system.

Lab Tests

In addition to imaging tests, several lab tests can be used to diagnose neurogenic bladder:

• Urinalysis: This test examines the urine for signs of infection, blood, or other abnormalities.
• Urine culture: A urine culture can help identify any bacterial infections that may be contributing to the condition.
• Serum blood urea nitrogen (BUN) and creatinine: These tests measure the levels of waste products in the blood to assess kidney function.

Other Tests

Other tests may also be used to diagnose neurogenic bladder, including:

• Electroencephalogram (EEG): This test measures the electrical activity of the brain to identify any abnormalities.
• Post-void residual volume: This test measures the amount of urine left in the bladder after urination.

References

1. [5] The preliminary evaluation consists of history taking, and a bladder diary and may be supplemented by tests such as uroflowmetry, post-void residual volume, renal ultrasonography to detect hydronephrosis.
2. [7] Radiologic testing: This includes an ultrasound or a voiding cystourethrogram (VCUG), which is an X-ray exam of your child's bladder and lower urinary tract.
3. [8] Imaging tests. These can include an ultrasound, X-ray, MRI, or CT scan. They may also put a dye into your bladder (contrast agent) to help visualize the urinary system.

Note: The above information is based on the search results provided in the context block.

Treatment Options for Neurogenic Bladder

Neurogenic bladder, also known as neurogenic detrusor overactivity (NDO), is a condition where the bladder muscle becomes overactive due to nerve damage or dysfunction. The treatment options for neurogenic bladder involve medications and other interventions to manage symptoms and improve bladder function.

Medications Used in Neurogenic Bladder Treatment

Several medications are used to treat neurogenic bladder, including:

• Antimuscarinics: These medications relax the bladder muscle and reduce spasms. Examples include oxybutynin (Ditropan) and tolterodine (Detrol).
• Bethanechol: This medication stimulates certain nerves that help control bladder function.
• Botulinum toxin (Botox): Injected into the bladder muscle, Botox can help relax overactive muscles.

Other Treatment Options

In addition to medications, other treatment options for neurogenic bladder include:

• Catheters: These are often used in cases of underactive bladder or when medication is not effective.
• Botulinum toxin (Botox) injections: As mentioned earlier, Botox can be injected into the bladder muscle to relax overactive muscles.

Combination Therapy

In some cases, a combination of medications and other interventions may be used to treat neurogenic bladder. For example, antimuscarinics may be used in conjunction with catheters or botulinum toxin injections.

References:

• [1] Imipramine has been historically used to treat nocturnal enuresis in children and adults, but has also been effectively used to treat neurogenic DO (Cole and ...).
• [3] In children with neurogenic bladder, CIC is the first-choice treatment to empty the bladder adequately (no residue, no infection) and safely (prior to high-...).
• [4] Medicines that relax the bladder (for example, oxybutynin or tolterodine) are used in neurogenic bladder treatment.
• [6] Catheters: This is often a treatment used for underactive bladder.
• [7] Botulinum toxin (Botox ®) can be used to improve autonomic dysreflexia and improve bladder storage.

The differential diagnosis for neurogenic bladder involves considering various conditions that may present with similar symptoms. According to the search results, some possible differential diagnoses include:

• Bladder outlet obstruction: This can cause urinary retention and other symptoms similar to those experienced in neurogenic bladder [7].
• Cystic pelvic mass: A cyst or tumor in the pelvis can lead to urinary symptoms that may be mistaken for neurogenic bladder [7].
• Posterior urethral valves: A congenital condition where the urethra is blocked, leading to urinary retention and other symptoms similar to those experienced in neurogenic bladder [7].

It's also worth noting that imaging studies such as ultrasound or CT scans can help rule out these conditions by identifying any anatomical abnormalities. However, a thorough medical evaluation and consultation with a specialist are necessary for an accurate diagnosis.

References: [7] Mar 22, 2024 — Differential diagnosis. Imaging differential considerations include: bladder outlet obstruction. cystic pelvic mass. posterior urethral valves. [7] is cited multiple times as it contains the list of differential diagnoses.