Neurourology focuses on disorders of the bladder related to spinal injuries and neurological disorders, more commonly referred to as neurogenic bladder.
Normal bladder function is dependent on the nerves that sense the fullness of the bladder. With nerve disorders, these feelings are affected, causing abnormalities in the bladder function, a neurogenic bladder.
Neurogenic bladder can be the result of a brain or spinal cord injury or a disease that interrupts nerve conduction in the pelvic area and results in loss of bladder sensation and motor control.
How is a neurogenic bladder diagnosed?
To diagnose a neurogenic bladder, the doctor will take your medical history and perform a physical exam. He will need to determine the type and severity of the disorder. Depending on the information gained the urologist may prescribe one or more diagnostic procedures to develop an effective treatment plan.
A urine flow test or pressure flow cystometry may be used. Another test records fluid intake and urinary output, sometimes using a catheter to empty the bladder, and a cystoscope can be used to assess the anatomy inside the bladder.
How is neurogenic bladder treated?
Treatment for neurogenic bladder depends greatly on the diagnosis and severity of the problem. Your doctor may use catheterizations, medications, control of fluids, even exercise. An anticholinergic medication may be used to treat incontinence associated with a nervous system disorder (e.g., Parkinson’s disease, multiple sclerosis, cerebral palsy). These medications relax bladder smooth muscle. In extreme cases, a urinary diversion is necessary, which involves re-routing of the urinary stream.
Intermittent self-catheterization is a safe and effective method of completely emptying the bladder every 3 to 8 hours, or as recommended by your doctor. Your fluid intake is directly related to urine output and the frequency of catheterization. The typical fluid intake is 48 to 64 ounces per day.
If catheterization is being used, one should never skip it. It is crucial to empty the bladder on a schedule. The risk for infection is greater from a full bladder than from an unwashed catheter so even if it is accidently dropped, it should be washed and used on time and not delay the catheterization more than an hour or two.
If you get any of the following symptoms, it most likely means your bladder needs to be emptied; chills, distended bladder, feeling of fullness, headache, perspiration, or restlessness.