Neurogenic Bladder

The bladder has two main functions:

• Storage of urine and then to
• Empty the urine when it is full.

 
For this process to be successful, the nerves and the muscles of the urinary tract must work together. Nerves carry messages from the bladder to the brain and from the brain to the muscles of the bladder and sphincter .

The messages from brain centre tell the bladder muscle when to relax or contract.

In a neurogenic bladder, the nerves that are supposed to carry these messages to the bladder do not work properly so the bladder is not able to store or empty urine effectively.

Symptoms of neurogenic bladder may vary depending upon the cause and other associated conditions.

• Urine leakage/dribbling/incontinence
• Urine retention,
• Recurrent fever,
• Pain abdomen/flanks.
• Weakness in lower limbs,
• Swelling lower back

Tests to confirm the diagnosis and extent of the condition include:

• ULTRASOUND (KUB/Abdomen) to evaluate the anatomy of the kidneys and bladder, tumours retroperitoneum.
• URODYNAMIC STUDY/ Video urodynamic study to evaluate how well your child’s bladder fills, stores urine and empties
• MCU/Voiding cystourethrogram to evaluate for Vesicoureteral Reflux (VUR), bladder neck and urethral problems.
• MRI of the spine to evaluate congenital anomalies ,tumours 0f spine and pelvic cavity and tethered spinal cord.
• Blood investigations- CBC, KFT, Basic Metabolic work up and Cystatin-C

• Clean intermittent catheterization (CIC)
• Overnight catheter drainage
• Prophylactic antibiotic therapy
• Anticholinergic medications
• Beta3 Agonist Medication