The normal function of the urinary bladder is to store and expel urine in a coordinated, controlled fashion. This coordinated activity is regulated by the central and peripheral nervous systems.
A neuropathic (or neurogenic) bladder is a term applied when there is disruption of the urinary bladder from within the central nervous system or peripheral nervous system. Disruption may be in the form of injury to the brain or spinal cord from trauma, Multiple Sclerosis, Parkinson’s disease, Stroke or Diabetic Neuropathy.
The symptoms of a neuropathic bladder vary depending on the site of neurological damage. Clinical features may range from detrusor underactivity to detrusor overactivity. The urinary sphincter may also be affected and result in overactivity and loss of coordination between the bladder contracting and the sphincter relaxing to allow urine to be expelled. Other features include incontinence, difficulty voiding, recurrent urinary tract infections and secondary renal issues.
The appropriate management of a neuropathic bladder is dependent on type of disruption to the nervous system, patient’s symptoms, a voiding history and selective imaging including video urodynamics studies and renal ultrasound. Other factors taken into consideration include patient’s mobility and hand function, level of damage to the nervous system, progressiveness of disease.
At North Eastern Urology, we provide expert advice and management to patients who have developed a neurogenic or neuropathic bladder. Our management will be dependent on result findings from your diagnostic tests including other factors as listed above.