Treatment for neurogenic bladder will depend on the underlying cause
of your condition. Because symptoms of neurogenic bladder look similar
to other conditions, your doctor will take a full medical history,
perform a physical exam, use imaging techniques or urine cultures, and
may ask you to keep a “voiding diary” to keep track of how often you
urinate. Once other conditions are ruled out, neurogenic bladder can be
treated with behavioral therapy, catheterization, medication and
Behavioral Therapy for Neurogenic Bladder
Your doctor can work with you to regain control of your bladder using behavioral therapy.
A bladder training schedule
will help you get used to holding your urine for longer periods of time
by putting you on a voiding schedule, gradually increasing the time
between voiding until you can hold your urine for several hours at a
Kegel exercises, otherwise known
as pelvic flood muscle exercises, will teach you to relax and contract
the muscles that control urination. Many patients find that performing
Kegels regularly helps them to minimize leakage or more completely empty
Biofeedback uses a monitor and
electrodes on your skin to increase your awareness of urinary tract
activity and other sensations which contribute to urination. Biofeedback
is often used in conjunction with Kegel exercises to help you gain
control of the muscles involved in urination. Continued use of a voiding
diary may also help you become aware of the need to empty your bladder.
Medical Therapy and Devices for Neurogenic Bladder
Several medications are available to help leakage and other symptoms associated with a neurogenic bladder.
relax the muscles of the bladder which decreases overactivity and
bladder spasms. This results in a decrease in leakage and urgency. Antispasmodic drugs also relax the muscles of the bladder, which increases the capacity of the bladder and decreases voiding frequency.
antispasmodic drugs and anticholinergic drugs can interfere with mental
alertness and physical coordination. Talk to your doctor about driving
safety or operating heavy machinery if you are taking these drugs.
such as tricyclics are not approved by the Food and Drug Administration
(FDA) specifically for neurogenic bladder treatment, but many doctors
find that tricyclics effectively treat the condition.
Botulinum toxin (Botox)
can be injected directly into the bladder to paralyze the muscles of
the bladder and control overactivity. Botox injections need to be
re-administered every six to eight months.
Sometimes a urinary catheter
is used to help a person with a neurogenic bladder void. The catheter
can be left in place (indwelling catheter) or re-inserted four to six
times a day (intermittent catheterization). Some people insert the
catheter on their own, and some people have a healthcare provider insert
the catheter. Ongoing catheterization can cause infection, urinary
tract injury, bladder spasm, and/or allergic reaction to the catheter
Surgery for Neurogenic Bladder
If behavioral therapy, medications and medical devices are ineffective, your doctor may consider surgery.
An artificial sphincter
can be surgically implanted into your bladder to prevent urine leakage.
The artificial sphincter is controlled by a pump which is used to
inflate the device to prevent urine leakage, or the sphincter can be
deflated to allow the urine to flow out of the bladder.
A piece of synthetic mesh or tissue can be placed under the urethra in bladder neck sling surgery to increase resistance in the urethra and prevent incontinence.
In bladder augmentation surgery (enterocystoplasy)
the bladder is expanded using a section of the bowel. After bladder
augmentation a patient will need to relieve themselves using a catheter.
When bladder augmentation is not possible, urinary diversion surgery may be performed to bypass the bladder.
of the many types of urinary diversion surgery involve diverting the
path of urine from the bladder, either by using a piece of bowel to
create a pouch to hold urine inside the body, or by redirecting the flow
of urine through a stoma, a small permanent hole in the skin of the
Talk to your doctor about what treatment options are right for you.