The bladder, a muscular organ that stores and voids urine, requires communication between the muscles of the bladder wall, the sphincter muscle, the pelvic floor muscles that support the bladder and the nerves surrounding the bladder. A neurogenic bladder describes a lack of bladder control due to damage to the nerves that control bladder functions. A neurogenic bladder can cause the inability to urinate, an overactive bladder, urinary incontinence and urinary urgency causing many women to feel isolated. If left untreated, a neurogenic bladder can result in kidney disease leading to the need for a kidney transplant or lifetime dialysis, according to the Cleveland Clinic.
Bladder Training
Training the bladder using a process of timed voiding can help to reduce the symptoms of an overactive bladder. As the bladder fills, nerves send signals to the brain. The brain send signals back to the bladder that tell the bladder muscle to contract and the sphincter muscle to relax therefore allowing the urine to pass into the urethra. When the nerves become damaged, due to an injury or a disease such as diabetes or multiple sclerosis, signals fail to trigger bladder muscle contractions.
Since a neurogenic bladder contracts irregularly, keeping a diary of fluid intake, times of urination and urine leakage, allows the patient to regain control over when and how often urination occurs. For women, adding kegel exercises, exercises that strengthen the pelvic floor muscles, can aid in bladder training and enhance the results, as described by the Cleveland Clinic.
Neuromodulation Therapy
Neuromodulation therapy, also called electrical-stimulation therapy, utilizes electrical impulses to stimulate the nerves. Since the nerves controlling the bladder run through the sacral region, the lowest portion of the spine just above the coccyx, doctors implant a small device in the buttocks. The device delivers electrical impulses to help stimulate the damaged nerves to send signals to and from the brain therefore restoring bladder function.
Drug Therapy
Medications can also help regain control over a neurogenic bladder. Anticholinergic medications, such as oxybutynin or propantheline, inhibit the action of acetylcholine---a neurotransmitter that triggers muscle contractions. By inhibiting acetylcholine from binding to receptors on muscles, anticholinergic drugs relax the muscle, in the case the bladder therefore relieving symptoms of an overactive bladder.
Sometimes a neurogenic bladder becomes underactive, meaning that all nerve signals fail resulting in a bladder that that fails to contract. Medications that stimulate nerves, such as bethanechol, can help treat this condition, according to MedLine Plus.
Catheterization
Many patients with a neurogenic bladder require catheterization in order to empty the bladder. Catheterization requires the insertion of a thin tube through the urethra and into the bladder. Patients can self-catheterize using Clean Intermittent Catheterization. This must be performed in sanitary condition to avoid urinary tract infections, which can irritate a neurogenic bladder even more.
