Complications

There are a number of health conditions linked to neurogenic bladder, which include urine retention, leakage, infection of the bladder or ureters, and damage to blood vessels in the kidney. Urine retention occurs when muscles hold urine in even when the bladder is full and ready to empty itself. On the other hand, leakage occurs when the muscles relax even when it is not time for urine to pass. Because urine is held in the bladder for too long, there is a higher risk of infection. The bladder can also apply tremendous pressure against the kidney when it is too full, causing damage to the kidney’s tiny blood vessels.

Causes

Causes and other factors that contribute to neurogenic bladder include acute infections, genetic nerve problems, diabetes, heavy metal poisoning, and accidents that result in damage to the spinal cord or brain.

Signs And Symptoms

The common signs and symptoms of neurogenic bladder include changes in urination, incontinence, painful urination, inability to thoroughly empty the bladder, and waking up a couple of times or more at night to urinate. Other signs and symptoms include hydroureteral nephrosis, vesicoureteral reflux, and upper urinary tract infection.

Diagnosis

Diagnosis may involve your doctor analyzing your symptoms, medical history, and results of your physical exam. You may be asked to keep a diary, which should indicate your urinary habits so that your doctor can design a bladder-training plan. Furthermore, your doctor may refer you to an urologist or urogynecologist when necessary. The tests you may undergo for diagnosis are urinalysis, bladder function tests, blood tests, ultrasound, and x-rays.

Treatment

For incontinence, overactive bladder and urine leakage, medications (which act to help muscles surrounding the bladder relax) are often prescribed. More severe cases may require a surgical replacement of the sphincter muscle, an increase in bladder size, or the construction of an alternate tube for draining the bladder. Because neurogenic bladder can cause infections like UTI, antibiotics may be prescribed. For those who have urinary retention or inability to urinate, a catheter may be used to consistently empty the bladder. In other cases, endoscopic surgery may be performed to enhance urine flow.

There really is no clear preventive method for neurogenic bladder. However, practicing a healthy lifestyle is said to help prevent neurogenic bladder. It has been found that the condition can be avoided or delayed if blood sugar levels are monitored (especially in diabetics) and if safety measures are taken to avoid spinal cord injuries.

Diagnosis

When you get a diagnosis for overactive bladder, your doctor will often examine your complete medical history, conduct a physical examination, order a urinalysis, and perform other specialized tests such as urodynamic, endoscopic, and imaging tests when necessary.

What Happens In Your System

In normal bladder function your bladder swells up when it is filled with urine. When it’s almost full, nerves surrounding it will signal your brain and loosen up your pelvic floor muscles so that urine can flow out. With involuntary bladder contractions, your muscles involuntarily contract even when the bladder is just half full. This is when you feel the sudden need to urinate. Sometimes, though, your bladder is unable to empty itself—this is called urge incontinence.

Causes

The causes of an overactive bladder include bladder abnormalities, urinary tract infection, inflammation surrounding the urinary tract, tumors, bladder stones, enlarged prostate, constipation, certain medications, diabetes, and excessive intake of caffeine or alcohol.

Symptoms

Finding yourself getting up twice or more times almost every night to use the bathroom is just one of the common signs of an overactive bladder. Other symptoms include having to urinate 8 or more times a day, frequently having the urge to urinate, leaking, anxiety over wetting, and feeling the sudden urge to urinate. You may feel anxious about whether or not there is a bathroom nearby such as when you are having a long meeting, stuck in traffic, or in public transport. You may also find yourself making sure you carry pads or similar devices in case leaking occurs.

Treatment

Typical drugs include oxybutynin chloride, tolterodine, and other antimuscarinics. These drugs act to relax the smooth muscle of the bladder. If you are diagnosed with overflow incontinence, you may be asked to keep a voiding diary, which includes occurrences of urination and leaking. With the information you provide, your doctor can help you plan what time of the day you can empty your bladder so you can prevent leakage. A patch may also be recommended, which is a device that distributes oxybutynin (treatment for overactive bladder) through the skin of your hip or abdomen. In more severe cases, surgery is required, where mild electrical pulses are used to stimulate nerves and relieve symptoms (sacral nerve stimulator), or a portion of your bladder is replaced (augmentation cystoplasy).

Prevention

As of today, the causes of overactive bladder are not completely clear, so preventive measures can only do so much. Though, it is still better to consume adequate amounts of fiber, exercise regularly, and limit your intake of caffeine and alcohol.

If you have one or more of the condition’s symptoms, you may have overactive bladder. However, get a proper diagnosis first, as some of the symptoms of overactive bladder can also be symptoms of other health conditions such as interstitial cystitis.