Neurogenic bladder is a disorder of urine storage and urination caused by a malfunction of the central or peripheral nervous system. The bladder itself may be healthy, but signals to it are poorly transmitted. There is no need for embarrassment here: it is a malfunction just like myopia, and it is discussed with a doctor.
What neurogenic bladder is
Neurogenic bladder dysfunction encompasses disorders of urine storage and urination in congenital or acquired abnormalities of the nervous system. Although the name mentions the bladder, it is actually about the lower urinary tract — the bladder and the urethra. Without monitoring, the condition can lead to kidney damage, pressure sores and urinary tract infections.
How bladder innervation works and what the detrusor does
Normal urination requires a working bladder, a working sphincter and the detrusor — the muscle of the bladder wall. During the filling phase, the bladder slowly stretches under low pressure. During the voiding phase, the detrusor contracts and the internal and external parts of the sphincter relax. Nerve signals travel between the brain and these muscles. If the nerves are damaged by disease or injury, the muscles do not contract and relax on time.
Causes of neurogenic dysfunction
Most often the cause is diseases of the central nervous system: Alzheimer's disease, congenital spinal cord defects such as spina bifida, brain or spinal cord tumors, cerebral palsy, encephalitis, attention deficit hyperactivity disorder, multiple sclerosis, Parkinson's disease, spinal cord injury, stroke. The second group is damage to the nerves supplying the bladder: neuropathy in severe alcoholism, diabetes, vitamin B12 deficiency, syphilis, after pelvic surgery, with intervertebral hernia or spinal canal stenosis.
Atony and other types of disorders
Symptoms depend on the cause. With an overactive bladder, a person urinates frequently in small volumes, does not empty the bladder completely, and loses control over it. With an underactive bladder — atony, or atonic bladder — there is a sensation of a full bladder with leakage, inability to feel filling, difficulty starting urination or urinary retention. Sometimes there are no symptoms, and incomplete emptying is found only during examination.
Why bladder overfilling is dangerous
Frequent bladder overfilling can irreversibly damage the muscle and overstretch the detrusor. Therefore, complaints of "I just don't feel that I need to go" are a reason for examination, not for endurance.
How it is diagnosed and when to see a doctor
The doctor asks about symptoms and diseases. Examinations include urine tests, imaging — X-ray, ultrasound, intravenous urography, examination of the bladder wall with a cystoscope. Further management is decided by a urologist or neurourologist. You should see a doctor if the bladder does not empty at all, there are signs of infection — fever, burning during urination, frequent urination — or urine is passed in small volumes frequently.
- frequent urges in small volumes
- feeling of incomplete emptying
- urine leakage without an urge
- difficulty starting urination
- loss of sensation of a full bladder
The condition itself is not a reason to call an ambulance. Call 103 or 112 if signs of a life-threatening condition appear, such as symptoms of a stroke.
This material is for reference: it explains what is happening but does not replace a doctor's consultation — the decision on examination is made by a specialist.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer