No one wants to deal with bladder-control issues. Whether you are experiencing occasional leakage or your urinary incontinence issues are more frequent, a urologist can help figure out what's causing these problems.
One condition your doctor may look into is called neurogenic bladder. It results when the bladder's muscles and nerves are not communicating properly with the brain. Nerve damage from conditions such as stroke, multiple sclerosis, spinal cord injury, or spina bifida can break down communication between the bladder and the brain.
If you are diagnosed with a neurogenic bladder, seek help. “There are different effective therapies that can help patients with neurogenic bladder to have less bothersome bladder symptoms," says Toby Chai, MD, vice-chair of research for Yale Medicine Urology. "At Yale Medicine, we take into account the long-term issues that are related to the neurologic diseases that are associated with the neurogenic bladder,” he says. The right treatment plan can help restore the greatest quality of life for patients.
What is neurogenic bladder?
Alzheimer’s diseaseNeurogenic bladder is a bladder dysfunction caused by damage to the body’s nervous system. Typically, the muscles and nerves of the urinary system work together to carry messages from the brain to the bladder.
When communications break down—because of a physical injury to the nervous system or other impairment—it can result in a loss of bladder control and problems such as kidney or bladder stones, leaking or incontinence.
Who is at risk for neurogenic bladder?
Neurogenic bladder is almost always connected to another condition. The most common conditions are Alzheimer’s disease, birth defects of the spinal cord, brain or spinal cord tumors, cerebral palsy, encephalitis, multiple sclerosis, Parkinson's disease, and spinal cord injury.
What are the symptoms of neurogenic bladder?
- Problems emptying all the urine from the bladder
- Loss of bladder control
- Symptoms of an underactive bladder include:
- Full bladder and urine leakage
- Inability to tell when the bladder is full
- Problems starting to urinate or emptying all the urine from the bladder
- Urinary retention
How is neurogenic bladder treated?
- Bladder training: A non-surgical approach helps patients learn the skills and exercises (such as Kegels) needed to strengthen the pelvic floor muscles. Some patients might be asked to keep a diary recording the time of urination and amount passed, so the patient can establish a more manageable pattern for urination.
- Catheterization: In this treatment, patients are taught how to self-insert a small catheter tube in order to empty the bladder at regular intervals.
- Sacral Neuromodulation: In this relatively new approach, small electrodes and a stimulator are inserted near nerves related to bladder function. The stimulator delivers the electrical impulses that the body would normally receive if the nerves were undamaged.
What makes Yale Medicine's approach to neurogenic bladder unique?
Patients can expect the most advanced treatment options available for neurogenic bladder, including sacral neuromodulation bladder injections and complex bladder reconstructive surgery.
“Our goal is to provide a patient-centered approach," says Dr. Chai. "So we work with your medical doctors including primary care physicians, neurologists, and specialists in physical medicine and rehabilitation (physiatrists) to ensure that you are taken care of holistically.”