Neurogenic bladder

'''For patient information page, click here

Overview
Neurogenic bladder refers to dysfunction of the urinary bladder due to disease of the central nervous system or peripheral nerves involved in the control of micturition.

Causes
Neurogenic bladder is often associated with spinal cord diseases, injuries, and neural tube defects including spina bifida. It may also be caused by brain tumors and other diseases of the brain, and by peripheral nerve diseases. It is a common complication of major surgery in the pelvis, such as for removal of sacrococcygeal teratoma and other tumors.

Treatments
Neurogenic bladder usually causes difficulty or full inability to pass urine without use of a catheter or other method. Consequently most treatments involve creation of a stoma that is continent and readily accepts a catheter. These are known as Mitrofanoff mechanisms. Anticholinergic medication may also be used.

Function of the stoma may be augmented by periodic injections of botulinum toxin to relax one of the two sphincters involved in normal urination. The effect is longer lasting with botulinum toxin type A than with type B. This use of botulinum toxin is discussed at length in the French medical literature.