Neurogenic Bladder -- Child

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Definition

Neurogenic bladder is a problem with how the bladder works because of a nerve problem. Problems may include:

  • Bladder empties too often.
  • Incontinence—bladder empties at the wrong time.
  • Urinary retention—unable to completely empty the urine.
  • Urine leaks out of the overfilled bladder.
Bladder With Nerves, Female
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Causes

Neurogenic bladder is caused by damage or injury to the nerves carrying messages between the bladder and the brain. The nerve damage makes it difficult to coordinate when the bladder should empty.

Risk Factors

Factors that increase the risk of neurogenic bladder include:

  • Birth defect that affects the spinal cord, such as spina bifida
  • Spinal cord injury
  • Tumors of the brain or spinal cord in the pelvic area
  • Infection of the brain or spinal cord

Symptoms

Symptoms may include:

  • Small amount of urine
  • Frequent urination
  • Dribbling urine
  • Inability to feel that the bladder is full
  • Straining during urination
  • Inability to urinate
  • Overflow of urine from a full bladder
  • Painful urination
  • Urinary tract infection
  • Kidney injury from urine backing up into the bladder
  • Kidney stones

These symptoms may be caused by other conditions. If your child has any of these symptoms, talk to the doctor.

Diagnosis

Your doctor will ask about your child’s symptoms and medical history. A physical exam will also be done. The doctor may ask you to keep a diary of how often your child empties his bladder and other urinary habits. The doctor may recommend tests to rule out other conditions:

  • Urinalysis—test of the urine to look for evidence of infection or kidney problems
  • Blood tests—to look for evidence of kidney problems
  • Bladder function tests—to measure how well the muscles of the bladder respond to filling and emptying

Tests may also be done to create images of the bladder and the rest of the urinary tract. Imaging tests may include:

  • X-rays
  • Ultrasound —to examine the kidneys, ureters, and/or bladder
  • CT scan —to make detailed images of the kidneys, ureters, and/or bladder
  • MRI scan —to create images of the brain and/or spinal cord

Treatment

Talk with the doctor about the best treatment plan for your child. Treatment options include the following:

Medication

The doctor may recommend that your child take antibiotics to prevent urinary tract infections.

Other medication may also be used to improve bladder function.

Catheters

A thin tube, called a catheter, can be inserted to empty your child’s bladder. You can learn to do this for your child, or a trained healthcare professional may do it.

Surgery

If other treatments fail, surgery may be an option. The exact type of surgery will depend on what is causing the problems. Some surgical options include enlarging the bladder or creating an artificial sphincter to control urine flow.

Prevention

Most cases of neurogenic bladder cannot be prevented.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 03/2014 -
  • Update Date: 05/05/2014 -
  • National Association for Continence

    http://www.nafc.org

  • Urology Care Foundation

    http://www.urologyhealth.org

  • BC Health Guide

    http://www.bchealthguide.org

  • Canadian/American Spinal Research Organization

    http://www.csro.com

  • Neurogenic bladder. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1348/mainpageS1348P0.html. Accessed June 25, 2013.

  • Neurogenic bladder. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/22629/router.asp. Accessed June 25, 2013.

  • Neurogenic bladder. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=9. Accessed June 25, 2013.