Neurogenic bladder

Neurogenic bladder is a urinary problem in which the bladder does not empty properly due to a neurological condition.

Causes
Neurogenic bladder is often associated with spinal cord diseases, injuries, and neural tube defects including spina bifida. It may also be caused by brain tumors and other diseases of the brain, and by peripheral nerve diseases. It is a common complication of major surgery in the pelvis, such as for removal of sacrococcygeal teratoma and other tumors.

What are the symptoms of neurogenic bladder?
The following are the most common symptoms of neurogenic bladder. However, each individual may experience symptoms differently. Symptoms may include:

urinary tract infection
kidney stones - these may be difficult to determine because you may not be able to feel pain associated with kidney stones if you have spinal cord abnormalities. Symptoms of kidney stones include:
chills
shivering
fever
urinary incontinence
small urine volume during voiding
urinary frequency and urgency
dribbling urine
loss of sensation of bladder fullness
The symptoms of neurogenic bladder may resemble other conditions and medical problems. Always consult your physician for a diagnosis.

How is neurogenic bladder diagnosed?
When neurogenic bladder is suspected, both the nervous system (including the brain) and the bladder itself are examined. In addition to a complete medical history and physical examination, diagnostic procedures for neurogenic bladder may include the following:

x-rays of the skull and spine - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
electroencephalogram (EEG) - a procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.
imaging tests of the bladder and ureters
tests that involve filling the bladder (to see how much it can hold and checking to see if the bladder empties completely)

Treatments
Neurogenic bladder usually causes difficulty or full inability to pass urine without use of a catheter or other method. Consequently most treatments involve creation of a stoma that is continent and readily accepts a catheter. These are known as Mitrofanoff mechanisms. Anti-cholinergic medication may also be used.

Function of the stoma may be augmented by periodic injections of botulinum toxin to relax one of the two sphincters involved in normal urination. The effect is longer lasting with botulinum toxin type A than with type B.

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