The urinary symptoms created by a neurogenic bladder depend on the cause or abnormality that has caused the problem. They often include urinary incontinence as well as frequent urination, an urgent sensation of urination, waking up at night to urinate (nocturia), inability to empty the bladder fully or an inability to urinate at all (urinary retention).
Common symptoms described as overactive bladder can also be due to a neurogenic bladder. Symptoms can include urinating frequently in small amounts, sensation of not being able to empty all urine from the bladder, and loss of bladder control. Overactive bladder may also be present in the absence of a defined neurological disease or disorder ("idiopathic overactive bladder.") Other symptoms can also be attributed to an underactive bladder, where the bladder cannot squeeze hard enough to empty completely, resulting in sensation of a full bladder that may be associated with urine leakage, inability to tell when the bladder is full, difficulty starting to urinate, or inability to empty urine from the bladder (urinary retention). This final condition may require use of a catheter to empty the bladder.
Assessment of the degree of urinary or voiding dysfunction may be assisted by creating a day-to-day record of urination. This commonly includes keeping a written diary of when you urinate, the amount you urinated, and if you leaked urine. This may help you learn when you should empty your bladder and when it may be best to be near a bathroom, as well as to provide a more quantitative assessment of your urinary problem.
Disorders and symptoms described as voiding dysfunctions can be due to a neurogenic bladder and should be evaluated to identify whether a neurogenic cause is present. Occasionally, neurogenic problems first manifest with urinary symptoms.
