Doctor insights on:
Can Neurogenic Bladder Be Cured
Managed yes: Nb is a permanent condition. Tempoary neurogenic-like symptoms can be present with bruising or compression of spinal cord, spinal meningitis or multiple sclerosis. A chinese physician has reported some success in curing some cases of nb by splicing normal nerves to bladder nerves. Otherwise considered not curable and treated by intermittent catheterization, artificial urinary sphincter implant etc. ...Read more
The bladder is a muscular organ in the pelvis that accepts urine from the kidneys, stores the urine at low pressure, & expels the urine during voluntary voiding. Though seemingly a simple reservoir, the bladder is a complex organ intricately connected with the brain and spinal cord with sensory, motor, and autonomic circuits. The muscular layer that contracts during voids ...Read more
Perhaps: If the etiology of the neurogenic bladder is cord or nerve compromise (such as severe stenosis, herniated disc, or other compression), then decompression of the nerves will lead to functional improvement, so long as the nerve compromise has not been lasting and neurovascular compromise has not taken effect. ...Read more
Essentially no.: Bruising of spinal cord can cause temporary neurogenic bladder which resolves spontaneously. Occasional cure has been reported by nerve transfer and anastomosis and is a possible hope for the future. Urinary incontinence can be managed in most cases by intermittent catheterization, with or without medication, artificial urinary sphincters, bladder augmentation or urinary diversions etc. ...Read more
It is treatable: The first line agents to manage neurogenic bladder, or more specifically, detrusor overactivity, are anticholinergic medications such as oxybutinin or tolterodine. Ultimately, if no benefit is gained from these medications, a trial of onabotulinumtoxina (botox) injections in the bladder wall may be tried and has been found to control the symptoms of incontinence for up to a year. ...Read more
Unfortunately not: There are a number of management/treatment options for neurogenic bladder, but no actual cure. We can help may patients with medication to increase bladder capacity, relax or tighten urinary sphincter with or without intermittent catheterization. Can also enlarge bladder capacity surgically with an intestinal augmentation cystoplasty or manage incontinence with an artificial urinary sphincter. ...Read more
Possibly: If the onset is very recent and is due to nerve compression that can be reversed it may be curable. An example is an acute lumbar disc herniation that is treated quickly with surgery. If the condition is chronic it is less likely to respond to treatment though it still may. In chronic cases treatment usually focuses on managing the problem. ...Read more
Bladder dysfunction: Due to lack of control &/or sensation of bladder or urinary sphincter function caused by diseases of brain, spinal cord or peripheral nerves. Congenital as in subjects with spina bifida and meningomyelocele, or acquired as in spinal cord injury, multiple slerosis etc. Can cause urinary incontinence from sphincter non-function or storage failure or inability to initiate urination (urinary retention. ...Read more
Damaged or no nerves: Between brain and bladder. Some children born with spina bifida & myelomeningocele & other spinal abnormalities or cerebral palsy have congenital neurogenic bladder. Spinal cord injuries or tumors, transverse myelitis, brain tumors or injuries, multiple sclerosis, diabetes can all cause nb. Basically, any interruption, of sensory or motor nerve impulses to or from bladder &/or sphincter cause a nb. ...Read more
Urodynamics: Urodynamics refers to the process of testing the bladder for its ability to accommodate filling, the pressure at which it does so, symptoms that filling may cause as well as evaluating flow rate and leakage, if any. This can be done in a relatively simple fashion in the office, or in a more sophisticated clinic setting with video and fluoroscopic information added to the basic information above. ...Read more
Symptoms of overactive bladder:
having to urinate too often in small amounts
problems emptying all the urine from the bladder
loss of bladder control
symptoms of underactive bladder:
bladder becomes too full and you may leak urine. Inability to tell when the bladder is full
problems starting to urinate or emptying all the urine from the bladder
urinary retention. ...Read more
Here is...: A form of dysfunction of urinary bladder and urinary sphincter leading to poor urine flow, urinary urgency or stress urinary incontinence, poor bladder emptying, an upset patient. Its causes may be spinal cord injury by accident or surgery or certain diseases like stroke, MS, diabetes, etc. ...Read more
To self sufficiency: Most wheel chair bound paraplegics crave independence, many quads do as well, but this is harder to acheive. Thus help subject to become independent. Hopefull subject can learn to perform self intermittent catheterization, via urethra or cutaneous catheterizable stoma from wheel chair. To transfer to toilet or commode for bms & by digital stimulation, suppositories, or enemas. Accompany to rehab visits. ...Read more
Atonic Bladder: Can result from holding back urination constantly or repeatedly, but isn't very common. Over the years have seen a couple of patients who developed atonic bladders from chronic suppression of urge to urinate. They essentially became neurogenic bladders & had to manage bladder emptying by self clean intermittent catheterization. However, strictly speaking you cannot develop NB by holding urine ...Read more
Possibly: If the onset is very recent and is due to nerve compression that can be reversed it may be curable with surgery. An example is an acute lumbar disc herniation that causes neurogenic bladder. If the condition is chronic it is less likely to respond to treatment though it still may. In chronic cases treatment usually focuses on managing the problem and may include self catheterization. ...Read more
Have neurogenic bladder. I currently in trial phase of sacral stimulation. Last week my symptoms were perfect, today I again felt retention, why is that?
InterStim Adjustment: During the trial phase of interstim, some adjustments may be necessary. It is possible for the lead to move a little bit, which can alter the effectiveness of the nerve stimulation. You should call the device rep and ask them to help you adjust which position on the lead is stimulated and/or change the stim amplitude. ...Read more
Same: urinary tract infections are treated with antibiotics other one has a normal bladder or an overactive bladder or a neurogenic bladder. since neurogenic bladder's often are symptomatic when no infection is present, it is especially important to have a urine culture prior to anabiotic therapy ...Read more
Variable: A neurogenic bladder can be irritable, causing urgency incontinence, or flaccid resulting in inability to pass urine, and often bladder problems are very complex. A urology evaluation can often point the way to appropriate medicines. However, best to rule out infection as this can cause many bladder problems. ...Read more
Surely: Since there are many variations of types of neurogenic bladders, cystometric examination will help categorize, and point the way for successful medication intervention. ...Read more
Though having neurogenic bladder I lost only some functions. Doctor says I am a good candidate for neurostimulation. Will I be benefited from it?
Probably not: Interstim device by medtronics is not indicated, nor approved for neurogenic bladder dysfunction. Is approved for treatment of urinary retention & symptoms of overactive bladder such as urge incontinence & urinary urgency-frequency. Use for neurogenic indications would be strictly off label & surgeon should have informed u. Suggest u consult neurourologist at johns hopkins, as u live in baltimore. ...Read more
A form of dysfunction of urinary bladder and urinary sphincter leading to poor urine flow, urinary urgency or stress urinary incontinence, poor bladder emptying, an upset patient. Its causes may be spinal cord injury by accident or surgery or certain diseases like ...Read more
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