THE NEUROGENIC BLADDER - A common problem in Parkinson’s

Definition: The Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination.

The most common symptoms of neurogenic bladder are:

Urinary tract infection (UTI)

Kidney stones.

Urinary incontinence (unable to control urine)

Small urine volume during voiding.

Urinary frequency and urgency.

Dribbling urine.

Loss of feeling that the bladder is full.

In a normal bladder, the muscles and nerves of the urinary system work together to hold and release urine at the right time. Nerves carry messages between the bladder and the spinal cord and brain. The messages tell the muscles of the bladder to either tighten or release. In neurogenic bladder, these nerves do not work the way they should.

Any number of things can cause a neurogenic bladder, probably the most common are:

Diabetes

Infections

Accidents that cause injury to the brain or spinal cord

Genetic nerve problems

Heavy metal poisoning

Brain or spinal cord tumors

Because the symptoms of neurogenic bladder may look like other conditions it is advisable to speak with your healthcare provider for an accurate diagnosis and treatment plan.

   If your healthcare provider, typically a urologist, thinks you might have a neurogenic bladder, s/he will want to check your brain, spinal cord, and bladder. S/he will review your health history and do a physical exam, and then proceed to other tests like:

X-rays of the skull and spine. This imaging test uses invisible energy beams to make images of tissues, bones, and organs.

Imaging tests of the bladder and ureters

Ultrasound (also called sonography). This imaging test uses high-frequency sound waves to create images of the organs on a computer screen.

Cystoscopy. Where a thin, flexible tube and viewing device is put through the urethra to examine the urinary tract. It checks for structure changes or blockages, such as tumors or stones.

Tests that involve filling the bladder, such as urodynamics. These tests show how much the bladder can hold and check to see if it fully empties.

Treatments for neurogenic bladder vary depending on the cause. They are aimed at preventing kidney damage and may include:

Medicines

Emptying the bladder with a catheter at regular times

Preventive antibiotics to reduce infection

Placing an artificial cuff around the neck of the bladder which can be inflated to hold urine and deflated to release it

Surgery to remove stones or blockages

Botox injections into the bladder muscle

Placement of an electrical device to stimulate or slow down bladder activity

Symptoms often linked to a neurogenic bladder:

Urine leakage often happens when the muscles holding urine in do not get the right message.

Urine retention happens if the muscles holding urine in do not get the message that it is time to pass urine.

Damage to the tiny blood vessels in the kidney may happen if the bladder becomes too full and urine backs up into the kidneys. This causes extra pressure and may lead to blood in the urine.

Infection of the bladder, ureters, or kidneys often results from urine that is held too long before it is passed out of the body.

To help make your diagnosis and treatment more affective, when you visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

Ask the Provider for permission to audio tape the visit, or;

At the visit, write down the name of any new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. ESPECIALLY know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

A second opinion may also be helpful – this is not your automobile, this is your body.