What Is Neurogenic Bladder?

Neurogenic bladder is a condition where the nerves that control the bladder do not work properly. This leads to problems with storing urine, emptying the bladder, or both. The issue is not with the bladder itself, but with the communication between the brain, spinal cord, and bladder.

Under normal conditions, nerves send messages from the brain to the bladder to signal when it is time to store or release urine. In neurogenic bladder, nerve damage or nerve-related diseases interrupt these messages, which can cause either an overactive bladder or an underactive bladder.

This condition can be caused by:

• Spinal cord injuries
• Multiple sclerosis (MS)
• Parkinson’s disease
• Stroke
• Diabetes
• Spina bifida (a birth defect affecting the spine)
• Brain or nerve tumors
• Surgery involving the pelvic region or spine

There are two main types of neurogenic bladder:

• Overactive (spastic) bladder: The bladder muscles contract too often or at the wrong time. This causes sudden urges to urinate, frequent urination, and possibly urine leakage.
• Underactive (flaccid) bladder: The bladder cannot contract strongly enough to empty fully. This leads to infrequent urination, a weak stream, and urinary retention, which may increase the risk of infections or kidney damage.

Symptoms may include frequent urination, leaking, inability to start or stop urination easily, urinary retention, or infections. In some cases, a person may not feel the urge to urinate at all, even when the bladder is full.

Diagnosis usually involves detailed history, urine tests, bladder scans, and sometimes urodynamic studies to assess bladder function.

Treatment depends on the type and severity. It may include medications to relax or stimulate the bladder, catheters to help empty urine, bladder training, and in some cases, surgery.