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Neurogenic Bladder Disorder

A neurogenic bladder, also known as a neuropathic bladder, is any malfunctioning bladder that has experienced neurological damage, either via injury, disease or trauma. Neurological damage can be the result of a malfunction of the brain, spinal cord or any number of nerves that affect the bladder.

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Neurogenic Bladder Disorder Causes

The body's urination process is controlled by the central nervous system, which includes the brain and spinal cord. Therefore, lesions, disease or injuries to these areas can cause neurogenic bladder disorder.

In the case of a neurogenic bladder, sometimes the brain does not send the messages required for the bladder to tighten and release properly. At other times, areas in the spinal cord may not be able to process the signal correctly. It takes only one of these nerve systems to be misfiring or not firing at all to negatively impact the urinary system.

The particular cause of neurogenic bladder disorder can range from many diseases or injuries, including:

accidents that cause trauma to the brain or spinal cord
acute infections
alcoholism
diabetes
genetic nerve problems such as multiple sclerosis and amyotrophic lateral sclerosis
heavy metal poisoning
spina bifida
spinal cord injuries
stroke
syphilis.

Types of Neurogenic Bladder

A neurogenic bladder can come in two forms:

Flaccid Bladder: A flaccid, or hypotonic, bladder ceases to contract fully, causing urine to dribble out of the body. Besides the complications that stem from urine dripping, rashes can occur in the area where urine pools. This type of bladder disorder occurs when the volume of urine is large but the pressure is low.
Spastic Bladder: A spastic, or reflex, bladder occurs when the volume of urine is normal or small, but there are involuntary contractions, causing a person to feel the need to urinate even when he doesn't need to release urine.

Many complications can result from a flaccid or spastic bladder. For example, damage to tiny blood vessels in the kidneys can occur from excess pressure. Additionally, the urine can become infected if it is held in the bladder for too long.

Neurogenic Bladder Symptoms

The following symptoms are often associated with neurogenic bladder. A person who has these symptoms should consult his doctor:

bed wetting
constant need to urinate
feeling that the bladder is never empty
urinary incontinence, such as the release of large volumes of urine or frequent dribbling of small amounts of urine
urinary tract infection (UTI).

In addition to these symptoms, kidney stones may also be a problem with neurogenic bladder disorder.

Neurogenic Bladder Treatment

One of the methods used to help a patient with a neurogenic bladder is to use a catheter or to empty the bladder at regular intervals.

As for medication, doctors usually prescribe:

anticholinergic drugs (drugs that inhibit the communication of certain nerve cells)
antispasmodics (drugs that prevent certain muscles from contracting)
muscle relaxants

Preventative antibiotic therapy may also reduce the incidence of infection.

Other treatments include placing an artificial sphincter around the neck of the bladder. The sphincter can be inflated to prevent urinary incontinence and then deflated when it is time to empty the bladder.

See a doctor if you have symptoms of neurogenic bladder. A medical professional can give you an accurate diagnosis and determine the best treatment method for your particular case.

Resources

eMedicine Health (2007). Neurogenic Bladder. Retrieved October 5, 2007, from the eMedicine Web site: http://www.emedicine.com/med/topic3176.htm.

Merck (2007). Neurogenic Bladder. Retrieved October 5, 2007, from the Merck Web site: http://www.merck.com/mmpe/sec17/ch228/ch228d.html.

University of Virginia (2007). Neurogenic Bladder. Retrieved October 5, 2007, from the University of Virginia Health System Web site: http://www.healthsystem.virginia.edu/uvahealth/adult_urology/

neurblad.cfm.

USA Today Health Encyclopedia (2007). Neurogenic Bladder. Retrieved October 5, 2007, from the USA Today Health Encyclopedia: Diseases and Conditions Web site: http://www.healthscout.com/ency/68/391/main.html.

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