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Neurogenic bladder

Neurogenic detrusor overactivity; NDO; Neurogenic bladder sphincter dysfunction; NBSD

Neurogenic bladder is a problem in which a person lacks bladder control due to a brain, spinal cord, or nerve condition.

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Voiding cystourethrogram

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Causes

Several muscles and nerves must work together for the bladder to hold urine until you are ready to empty it. Nerve messages go back and forth between the brain and the muscles that control bladder emptying. If these nerves are damaged by illness or injury, the muscles may not be able to tighten or relax at the right time.

Disorders of the central nervous system commonly cause neurogenic bladder. These can include:

Damage or disorders of the nerves that supply the bladder can also cause this condition. These can include:

Symptoms

The symptoms depend on the cause. They often include symptoms of urinary incontinence.

Symptoms of overactive bladder may include:

Symptoms of underactive bladder may include:

Treatment

Medicines may help manage your symptoms. Your health care provider may suggest:

Your provider may refer you to someone who has been trained to help people manage bladder problems.

Skills or techniques you may learn include:

Learn to recognize the symptoms of urinary infections (UTIs), such as burning when you urinate, fever, low back pain on one side, and a more frequent need to urinate. Cranberry tablets may help prevent UTIs.

Some people may need to use a urinary catheter. This is a thin tube that is inserted into your bladder. You may need a catheter to be:

Sometimes surgery is needed. Surgeries for neurogenic bladder include:

Electrical stimulation of the tibial nerve in the leg may be recommended. This involves placing a needle into the tibial nerve. The needle is connected to an electrical device that sends signals to the tibial nerve. The signals then travel up to the nerves in the lower spine, which control the bladder.

Support Groups

If you are having urinary incontinence, organizations are available for further information and support.

Possible Complications

Complications of neurogenic bladder may include:

When to Contact a Medical Professional

Call your provider if you:

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References

Chapple CR, Osman NI. The underactive detrusor. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 118.

Goetz LL, Klausner AP, Cardenas DD. Bladder dysfunction. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 20.

Panicker JN, DasGupta R, Batla A. Neurourology. In: Daroff RB, Jankovic J, Maziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 47.

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Review Date: 6/23/2020  

Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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