Medicine for Neurogenic Bladder
Medicines may help manage symptoms. Your health care provider may suggest:
- Overactive bladder medicines that relax the bladder such as oxybutynin, tolterodine, or solifenacin, as well as mirabegron
- Bladder muscle injections to relax the bladder, such as injection of Botulinum toxin
- Other types of medication that can affect the nervous system such as GABA supplements and anti-epileptic drugs
Most of these treatments help to calm an overactive bladder. Unfortunately, there are few, if any, treatments to improve the strength of the bladder muscle.
Behavioral Training for Neurogenic Bladder
Your provider may also help people manage bladder problems with various approaches to behavioral training or counseling sessions that may include:
- Limitation of fluid intake (e.g., decreasing fluid intake after dinner to decrease the number of times that an individual has to get up at night to urinate.)
- Pelvic floor therapy - teaching patients skills or techniques to control the muscles and nerves involved in urinating.
- Exercises to strengthen your pelvic floor muscles (Kegel exercises)
- Biofeedback to provide training to learn how to do the above with the aid of a computer.
Neurogenic Bladder and Urinary Tract Infections
Learning to recognize the symptoms of urinary infections (UTIs), such as burning when you urinate, fever, low back pain on one side, and a more frequent need to urinate are important to prevent a local bladder problem from becoming a more systemic infection as well as to decrease urinary symptoms.
Supplements and suppressive medications to prevent urinary infections, such as cranberry-based supplements, mandelamine (a medication to prevent bacterial growth) or specific vitamins may be considered for patients who are susceptible to infection.
Some patients with neurogenic bladder may need to use a urinary catheter. This is a thin tube that is inserted into your bladder through the natural urine passage (urethra). This may involve having a catheter in place all the time or indwelling catheter, intermittent catheterization in which the patient is trained to place a catheter in the bladder 4 to 6 times a day to empty the bladder for individuals who cannot empty the bladder themselves.
Surgery for Neurogenic Bladder
Potential surgical treatments for neurogenic bladder include:
- Artificial sphincter
- Electrical device implanted near the bladder nerves to stimulate the bladder muscles
- Sling surgery
- Creation of an opening (stoma) in which urine flows into a special pouch (this may include diverting urine away from the bladder, a "urinary diversion")
If you are having urinary incontinence, organizations are available for further information and support.
- National Association for Continence (nfac.org)
Complications of neurogenic bladder may include:
- Constant urine leakage can cause skin to break down and lead to pressure sores
- Kidney damage can occur if the bladder becomes too full, or if excess pressure in the bladder causes urine back up to the kidneys.
- Urinary tract infections.
When to Contact a Medical Professional?
Call your health care provider if you:
- Are unable to empty your bladder at all
- Have signs of a bladder infection (fever, burning when you urinate, frequent urination)
- Urinate small amounts, frequently
- Are otherwise bothered by your urinary pattern (i.e., urination affects your day-to-day quality of life.)