Neurogenic Bladder

Alternate Names : Neurogenic Incontinence, Neuromuscular Dysfunction of the Lower Urinary Tract, Neurologic Bladder Dysfunction, Neuropathic Bladder

What are the treatments for the condition?

The goals of treatment are to control infection, and prevent incontinence. This can be accomplished by regular evacuation of the urine from the bladder, medications, or surgery.

Evacuations of urine from the bladder include Crede's method, and intermittent self-catherization. Crede's method involves applying manual pressure with the use of the hand over the lower abdomen. This promotes complete emptying of the bladder.

Intermittent self-catherization involves the insertion of a rubber tube into the bladder on a set schedule to empty the bladder. A person can be trained to do this him or herself.

A male can use a condom catheter. A condom catheter looks like an ordinary condom that attaches at the end to a short tube leading into a drainage bag. The drainage bag catches the urine. The bag attaches to the leg or stomach and can be worn underneath clothing. Another option for drainage is a urinary catheter, a thin rubber tube that is inserted into the bladder and left in place.

If the bladder problem is not too severe, a medication called oxybutynin may be taken to relax the bladder. If the bladder wall relaxes enough, and the person purposely urinates often, the incontinence may be prevented.

Medications do not usually work for problems with the urinary sphincter. Surgery to repair the sphincter may be needed. Surgery is also used for bladder problems if they do not do not respond to medications. The urine is diverted to an outside opening made in the abdomen called an ostomy. This is accomplished by removing a short segment of the small intestines. The ureters are connected to this segment of small intestines. This is then attached to the opening in the abdomen. The urine is then collected in a bag that is applied to the abdomen.

What are the side effects of the treatments?

Medications to relax the bladder may cause dry mouth, constipation, and drowsiness. The use of a urinary catheter carries an increased risk of infection.

Surgery to enlarge the bladder with pieces of intestine can have the usual side effects of major intestinal surgery. These include a long time on a special diet, and some pain after surgery. Infection, bleeding, and rupture of the bladder are also possible.

What happens after treatment for the condition?

The person should be encouraged to drink plenty of fluids. This will help prevent urinary tract infections, bladder stones, and kidney stones. If surgery was performed, teaching will need to be done on the care of the ostomy.

How is the condition monitored?

A person with neurogenic incontinence needs to be watched to make sure the kidneys are not affected. This is done with kidney function blood tests, urine tests, and x-rays of the kidneys.