Neurogenic Bladder in Children
What is a neurogenic bladder?
Neurogenic bladder is a general term for bladder problems caused by nerve damage. Normally, the muscles and nerves of the urinary system work together to hold urine in the bladder and then release it at the right time. Nerves carry messages from the bladder to the brain and from the brain to the bladder muscles. These messages tell the bladder muscles either to tighten or release. In a neurogenic bladder, the nerves that are supposed to carry these messages don’t work properly. This has the effect of paralyzing the bladder.
What causes neurogenic bladder?
In children a neurogenic bladder may be caused by a birth defect. Or it may happen later because of a different problem. The following are some of the most common causes of neurogenic bladder:
Spina bifida. A defect that occurs during early fetal development. The defect consists of incomplete bony closure of the spinal cord through which the spinal cord may or may not protrude.
Spinal cord trauma
Central nervous system tumors
In many cases, neurogenic bladder is linked to the following:
Urine leakage. This often occurs when the muscles holding urine in the bladder do not get the right message.
Urine retention. This often happens if the muscles holding urine in the bladder do not get the message that it is time to let go.
Damage to the tiny blood vessels in the kidney. This often happens if the bladder becomes too full and urine backs up into the kidneys, causing extra pressure.
Infection of the bladder or ureters. This often results from urine that is held too long before being eliminated.
What are the symptoms of neurogenic bladder?
Each child’s symptoms may vary. It depends on the cause and other conditions that are linked to it.
The symptoms of neurogenic bladder sometimes look like other conditions or health problems. Always see your baby's healthcare provider for a diagnosis.
How is a neurogenic bladder diagnosed?
Your baby’s healthcare provider will take a medical history and give your baby a physical exam. Other tests used to diagnose neurogenic bladder may include:
Urodynamic study. During this study, your child's bladder will be filled with saline so that the bladder volume and pressure may be measured. The tone or amount of contraction of the bladder can also be determined.
What is the treatment for a neurogenic bladder?
Your baby’s healthcare provider will figure out the best treatment plan for your baby based on:
Your baby’s age, overall health, and health history
How sick he or she is
How well your baby can handle certain medicines, treatments, or therapies
How long the condition is expected to last
Your opinion or preference
Treatment may include:
Insertion of a catheter or hollow tube. This is done to empty the bladder at regular intervals.
Preventive antibiotic therapy. This is used to reduce the incidence of infection.
Placement of an artificial sphincter. This procedure that involves placing an artificial cuff around the neck of the bladder. This can be inflated to prevent urinary incontinence and deflated when it is time to empty the bladder. Children who have this will still need intermittent catheterization to completely empty the bladder.
Surgery. Your child’s healthcare provider will discuss surgery options with you.
Talk with your child's healthcare provider about any questions or concerns you may have.