Neurogenic bladder

What is neurogenic bladder?

3D man with Intestinal problems sitting on the toilet Neurogenic bladder is a condition in which the nerves that govern the urinary system and signal when urine should be held in or released from the bladder are disrupted, causing patients to lose bladder control.

The bladder can become either overactive (spastic or hyper-reflexive) or underactive (flaccid or hypotonic)

Overactive bladder (often seen with strokes, brain diseases and Parkinson’s disease). With overactive bladders, urination is frequent and uncontrolled, capacity is low and there is incomplete emptying. Bladder capacity may decrease because it is rarely filled to capacity. Residual urine, left if the bladder is not emptied completely, may lead to increased risks of urinary tract infections.
Underactive bladder (common in diabetes, polio, syphilis, multiple sclerosis, and prior radical pelvic surgery). With underactive bladders, there is a diminished sense of when the bladder is full and individuals cannot contract the sphincter muscles sufficiently, allowing urine to leak from the urethra as the bladder fills beyond its limits.

Causes

Conditions that can precipitate a neurogenic bladder include

Brain or spinal cord injury
Diabetes
Acute infections
Neurological disorders including Parkinson’s disease and stroke
Genetic nerve disorders
Heavy metal poisoning

Symptoms

Urinary incontinence
Frequent urination (urinating eight or more times daily)
Urgency (feeling the need to urinate immediately)
Dribbling urine
Loss of sensation of bladder fullness
Painful urination which may result from a urinary tract infection
Kidney stones

Diagnosis

Diagnostic tests can include:

The skull and spine may be examined with X-rays, computed tomography (CT), and magnetic resonance imaging (MRI)
An EEG to measure electrical activity in the brain
Imaging tests of the bladder and ureters
Urodynamic studies (bladder function tests) to measure bladder capacity, bladder pressures, the flow of urine, and bladder emptying.
Cystoscopy (where a telescope is used to examine the inside of the bladder and urethra)

How is Neurogenic Bladder Treated?

Your healthcare provider will work with you to decide on a treatment plan that is appropriate for what is causing the neurogenic bladder. Some neurogenic bladder treatment options include:

Lifestyle changes: These might include avoiding certain foods or drinks that can irritate your bladder. These include alcohol and certain caffeinated drinks like coffee and soda. Good blood glucose management for people with diabetes and constipation management can also help.
Clean intermittent catheterization (CIC): Catheters are thin, flexible tubes that can be inserted through your urethra and into your bladder to drain urine. You can learn how to do this yourself so that you can empty your bladder on your schedule.
Continuous catheterization: This method calls for a catheter to be worn at all times. The catheter is a small tube that can be placed through your urethra or the lower abdominal wall (suprapubic tube).
Drugs: Medications that treat neurogenic bladder include oxybutynin, tolterodine, mirabegron, solifenacin succinate, and others.
Injections of botulinum A toxin (Botox®): Your healthcare provider injects botulinum A toxin into your bladder or urinary sphincters.
Bladder augmentation (augmentation cystoplasty): In this surgery, a surgeon removes segments of your intestine (sigmoid colon) and attaches them to the walls of your bladder. This reduces the bladder's internal pressure and increases its ability to store urine.
Ileal conduit: Part of the small bowel is used to make a urine stoma. This stoma drains to a bag attached to the outside of the body.

Absorbent undergarments, pads, panty shields, panty liners, and adult diapers can help prevent wetness and odors while protecting skin and clothing. Bed pads can protect sheets and mattresses.

What Complications are Related to Neurogenic Bladder?

People who have neurogenic bladder are at higher risk for other urological problems, including repeated infections, kidney damage, vesicoureteral reflux, and stones that form in the urinary tract.

People with bladder control conditions such as neurogenic bladder may experience the quality of life issues. It’s important to recognize these issues and get help with them.

Patient Feedback for Z Urology

Our patients are the reason we strive for exceptional urological care and treatment! Here’s what some of our South Florida patients are saying about their experience at our clinics.

I have recommended many people to this office and each one has thanked me. On a scale of 1 to 5 (5 being the best), Dr. Z and his staff are a 12.
– Alex S.
The wait was not long. I was greeted by a friendly nurse who took my sonogram of the kidneys and bladder. The doctor came in after a short time. Dr. Hollowell has a gentle voice and great bedside manner. He is very informative about my issues and I left feeling relieved and hopeful for future visits. The receptionists were also helpful and friendly. I recommend this office. Just wish it was closer to home.
– Allison T.
"I found Doctor Varghese through my insurance provider network and read reviews in Healthgrades. Dr. Varghese is terrific. She explains things so they are easy to understand. I feel she is on top of several medical problems I’m having. I had a cystoscopy and was offered nitric oxide (mild gas). It was perfect. I have had the procedure in the past but it was the most uncomfortable feeling I ever experienced. Not this time. Doctor Varghese is an excellent listener and remembers what I tell her from the previous visits.

Let me sum up my feelings about being under Dr. Varghese's care. I have new health insurance now so I can see doctors near my home, but instead I’ll continue to drive 75 miles each way to and from Pompano Beach to Stuart, FL [to see her].”
– Jeffery P.
“I've been coming here for cancer for 10 years and I've had nothing but good visits every time. Staff is friendly and the doctors and PA'S are great. Dr. Z takes the time to ask questions and explain everything. He is amazing.”

– Bill S.
“El Dr. Pedro Espino Grosso es un médico especialista en Urología es también especialista en entender, comprender y atender la preocupación de su paciente. Gracias por su profesionalismo como para todo el staff y las enfermeras por su amable y compasivo trato. Por favor no cambien!”
– Ana L.
I have new health insurance now so I can see doctors near my home, but instead, I’ll continue to drive 75 miles each way to and from Pompano Beach to Stuart, FL to visit Z Urology!
– Jeffery P.
“Dr. Mini Varghese of Z Urology is without a doubt the best Urologist in South Florida. She not only takes care of my father but now she's taking care of all my needs too. The team she has behind her at Z Urology is amazing, they go up and beyond their call of duty. A big shoutout to Z Urology in Pompano Beach, FL, thanks for keeping the pipes flowing...you gals are the Best!!!! Thanks Dr. Varghese.”
– Brent S.
“Dr. Brar was awesome! He was very thorough with everything to ensure we got to the bottom of my issue! I felt like he cared and listened. I will be going back. The office was busy and some people were waiting a while but I was seen fairly quickly, I did fill out all the paperwork ahead of time so not sure if that helped! The person who helped me at the front desk was great and helped me with all my questions.”
– Britney C.
Everyone seemed nice, friendly and welcoming. I was also impressed with the examination and the way the staff treated me. Dr. Mike took the time with me to listen and advise me as to what treatment plan might be needed.
– Jimmy Z.
Great specialist, hard to find a more personable and efficient medical office anywhere else. I was welcome from the moment I came in, everyone was very friendly and all my questions and needs were expertly attended to. Never been to a urologist so this was new to me, but I definitely felt comfortable and heard. It was a drive from neighboring Miami but well worth it. Highly recommend. Thanks, Dr. Z!
– Jose T.
Thank you Dr. Michael Zahalsky for the surgery, you changed my life completely. I'm so happy, now no more pain and I'm feeling better than ever, thanks again for the great staff in your office. Very professional. Felt like family.
– Frank C.
They are very friendly. My surgeon went through the same procedure and read my mind of all my concerns. He reassured me everything would be okay and life would go on.
– Jeremy C.
Three words: Kind, Caring and Compassionate! This office is the best of the best. The front desk employees are super friendly and the doctors are professional and spoke to me in a down-to-earth & making it easier for me to understand what was going on. I am able to make informed decisions with the material that was provided to me.
– A.D.Z.
I had a great first visit with Dr. Z and his staff. I was seen within a reasonable amount of time. Dr. Z was personable and, after hearing my history and doing a targeted physical exam, directed his staff to perform ultrasound and bladder testing which was done efficiently and with discretion. Dr. Z then came in and spent a good amount of time explaining a clinical treatment plan. I left feeling I was in the hands of a total professional office from the top down.
– Harvey A.
Z urology is the best and I have to say Dr. Zahalsky is extremely knowledgeable and such a humble and pleasant human being. I always feel welcome at Z Urology.
– Kimaro W.

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