NuDigest: Understanding Neurogenic Bladder

Neurogenic bladder describes a number of urinary conditions caused by the malfunction of or trauma to the brain and the central nervous system. It occurs when the bladder is unable to relax or contract.

Millions of Americans live with neurogenic bladder. When the communication between the nervous system and bladder are disrupted by nerve damage, the ability of the bladder to fill and empty in a coordinated fashion is disrupted and may result in incontinence. The nerve damage can be caused by spinal cord injury; spina bifida; stroke; infection of the brain or spinal cord; or diseases such as diabetes, multiple sclerosis (MS) or Parkinson’s disease.

Neurogenic bladder presents in two ways: overactive bladder (OAB), or underactive bladder (UAB). Overactive bladder is the sudden and urgent spasms of the bladder muscles, regardless of the amount of urine in the bladder. This condition causes a frequent feeling of needing to urinate and may cause the involuntary loss of urine. With underactive bladder, the flow of urine is blocked by the bladder muscles not squeezing when they need to, producing a “dribble” of urine or preventing the emptying of the bladder leading to urinary retention. Some people may experience symptoms of both overactive and underactive bladder. It is most common in people with MS or stroke.

The symptoms of neurogenic bladder differ from person to person and depend on the type of nerve damage. Individuals with neurogenic bladder are more prone to urinary tract infections (UTIs); this is often the first symptom of neurogenic bladder. Other symptoms include: hematuria, pain, abnormal renal ultrasound and change in renal function.