A bladder that has lost function due to damage to its nerve supply is called ‘neurogenic bladder’.
Neurogenic bladder may occur as a consequence of:
- Spinal cord injury
- Multiple sclerosis
- Spina bifida
- Type 2 diabetes
- Stroke
- Parkinson’s disease
- Brain tumours
Although the nerve damage does not influence how the kidneys produce urine, a major consequence of the damage can be impaired functionality of the bladder's storage capacity and coordination between bladder contraction and sphincter relaxation.
There are two main categories of dysfunction associated with neurogenic bladder – reflex bladder and flaccid bladder:
Overactive (reflex) bladder
When the bladder muscles contract spontaneously as it begins to fill with urine, causing incontinence (i.e. accidental emptying) because the person is unaware of when the emptying will occur.
Underactive (flaccid) bladder
When the bladder can’t release urine because it tends to lose muscle strength and cannot contract properly for emptying. Without appropriate management, a flaccid bladder is at risk of overstretching and becoming damaged or infected because the person may be unable to feel when the bladder is full. Bacteria, therefore, will not be removed through urination and can spread into the bladder.
Some people may have ‘mixed bladder’ nerve damage. This means that the bladder may act like a flaccid bladder or a reflex bladder and may, therefore, have more varied and unpredictable symptoms.
The symptoms of a neurogenic bladder must be properly managed. If the bladder has lost its ability to empty, the preferred method is intermittent catheterisation.
