Neurogenic Bladder

This information explains the causes, diagnosis, and treatment of neurogenic bladder.

About Neurogenic Bladder

Neurogenic bladder is when your bladder isn’t working the way it should be due to a brain, spinal cord, or nerve problem. These problems can affect the nerves of your bladder and your ability to urinate.

People with neurogenic bladder:

  • Aren’t able to hold in their urine.
  • Have to urinate many times during the day or night.
  • Feel an urgency to urinate, but then are unable to.
  • Have incontinence (accidental leakage of urine from your bladder) because there is no feeling to urinate.
  • May experience urinary retention (the inability to completely empty out the bladder), which leads to urinary tract infections (UTIs).
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Diagnosing Neurogenic Bladder

To find out if you have neurogenic bladder, your doctor will:

  • Talk with you about your medical history.
  • Ask you questions about your urinary history.
  • Give you a physical exam.
  • Have you complete an ultrasound of the bladder. This is a procedure that uses sound waves to produce images of your bladder.
    • During this procedure, you will urinate and then have an ultrasound done to see how much urine remained in your bladder. No radiation is involved in this test.
  • Ask you to record the time at which you urinate and the amount of urine you pass for 3 days in a row
    • If you have to do this, your doctor will give you more information.

Your doctor may also order other tests, such as:

  • An ultrasound of your kidneys.
  • A urine analysis or urine culture. These are tests that check your urine to find germs (such as bacteria) that can be causing an infection. 
  • A urodynamic evaluation. This is a procedure to test how well your bladder is working.
  • A cystoscopy. During this procedure, your doctor takes a closer look at your bladder and urethra (tube that carries urine out of your body) using a scope (hollow tube with a tiny light on the end). This is done to check for problems in your urinary tract.

 

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Managing Your Neurogenic Bladder

The goal of treatment for neurogenic bladder is to control and manage your symptoms. Your treatment plan will be based on your diagnosis. You and your doctor will discuss which treatment is right for you.

Possible treatments include:

  • Double voiding
    • To do this, sit on the toilet and urinate as you normally do. When you’re finished urinating, stand up, sit down again, and try to urinate again. This may help with emptying your bladder.
  • Crede technique
    • This involves putting pressure on your bladder while you urinate. When urinating, make a fist with one hand and place it on your lower abdomen (belly), right below your navel (belly button). Place your other hand over your fist and apply pressure. This will help empty out your bladder completely.
  • Limit how much you drink in the evening
    • Increasing the amount of liquids you drink during the day and limiting the amount you drink in the evening can help you avoid accidental leakage at night.
  • Medication to relax your bladder
  • Pelvic floor therapy
    • This is a type of physical therapy that works on strengthening your pelvic floor muscles. You will first go to therapy twice a week for 6 weeks. Then, you will continue the exercises you learn at home.
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