To urinate efficiently, our bodies require unimpeded communication between the brain and the bladder, the hollow, muscular organ that stores urine. Using the body’s nervous system, the bladder signals the brain when it is full, and the brain, in turn, signals the bladder muscle to contract and discharge the liquid. When problems with the nervous system interfere with this signaling, the result is called neurogenic bladder.
Neurogenic bladder can upset the normal urination pattern by causing either an overactive bladder, with frequent muscle spasms that expel urine unexpectedly; or an underactive bladder that allows urine to accumulate to the bladder’s capacity and beyond, raising the risk of infection and other dangerous conditions. Unlike spastic bladder, neurogenic bladder often requires intervention with catheters and other devices that help control urine flow and facilitate the daily activities of life.
Alternatively, neurogenic bladder sufferers with less uncontrolled urine discharge often choose to wear special incontinence undergarments in place of catheterization. The latest generation of washable briefs for women and for men are available in several ranges of absorbency, with a comfortable fit and an odor control system.
The causes of neurogenic bladder range from birth defects to physical injuries to diseases that affect the central nervous system. Among seniors, the condition frequently is related to diabetes, stroke, Parkinson’s disease, a tumor affecting the central nervous system, spinal cord injury, and spinal or pelvic surgery.
In addition to their disruptive impact on quality of life, neurogenic bladders create the potential for such serious conditions as urinary tract infections, kidney stones, and, most dangerous of all, kidney damage. See a urologist promptly if you experience symptoms that include:
- any degree of urinary incontinence (loss of bladder control);
- pain or burning during urination;
- need to urinate frequently and suddenly;
- urinating small amounts at a time;
- absence of the normal feeling of a full bladder.
Treating and coping with neurogenic bladder
Depending on the nature and extent of nerve damage, neurogenic bladder can be treated with varying degrees of success with drugs that calm the bladder muscle, surgical procedures, changes in diet and certain exercises. For example, Kegels — exercises that strengthen the muscles surrounding the urethra, the tube through which urine is conducted out of the body from the bladder — often are recommended. Avoiding foods that can stimulate the bladder muscle, such as spices, caffeinated and carbonated beverages, chocolate, citrus fruits, and artificial sweeteners, can be helpful.
Still another potentially useful way to combat neurogenic bladder is a technique known as timed voiding or bladder training. It involves conditioning the bladder to discharge urine at timed intervals that are gradually lengthened. How-to information on timed voiding is provided here by The Harvard Medical School.
Despite these many approaches, however, most people with neurogenic bladder need catheters to control incontinence. Catheters are thin, flexible tubes that are inserted through the urethra into the bladder to enable free flow of urine, either into a collection bag or a toilet. A majority of catheter users with neurogenic bladder employ self-catheterization, which is learned in a hospital or clinic setting, or at home under the guidance of a health care professional. It may take several weeks to master self-catheterization, but most people do manage to become comfortable with the process, which enables them to enjoy relatively routine lifestyles.
Although neurogenic bladder cannot necessarily be cured, new generations of incontinence products can help mitigate its most damaging effects on quality of life.