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Neurogenic bladder - Treatment

Treatment:

Medications may help manage your symptoms. Your doctor may recommend:

  • Medicines that relax the bladder (oxybutynin or propantheline)
  • Medicines that make certain nerves more active (bethanechol)
  • Botulinum toxin (Botox)

Your doctor may refer you someone who has been trained to help people manage bladder problems. Skills or techniques you may learn include:

  • Exercises to strengthen your pelvic floor muscles (Kegel exercises)
  • Keeping a diary of when you urinate, the amount, and if you leaked urine. This may help you learn when you should empty your bladder and when it may be best to be near a bathroom.

Learn to recognize the symptoms of urinary infections, such as burning when you urinate, fever, low back pain on one side, and a more frequent need to urinate.

Some people may need to use a urinary catheter. This is a thin tube that is inserted into your bladder:

  • You may need a catheter to be in place all the time (indwelling catheter)
  • You may need a catheter to be placed in your bladder 4 to 6 times a day to keep your bladder from becoming too full (intermittent catheterization)

Sometimes surgery is needed. Surgeries for neurogenic bladder include:

  • Artificial sphincter
  • Electrical device implanted near the bladder nerves, to stimulate the bladder muscles
  • Sling surgery
  • Creation of an opening (stoma) in which urine flows out of the into a special pouch (this is called urinary diversion)

Support Groups:

See: Incontinence resources

Complications:

  • Chronic urine leakage can cause skin breakdown and pressure sores
  • Kidney damage may occur if the bladder becomes too full, causing pressure to build up in the tubes leading to the kidneys and in the kidneys themselves
  • Urinary tract infections

Calling your health care provider:

Call you health care provider if you:

  • Are unable to empty your bladder at all
  • Have signs of a bladder infection (fever, burning when you urinate, frequent urination)
  • Urinate small amounts, frequently
  • Reviewed last on: 4/30/2011
  • Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Wein AJ. Lower urinary tract dysfunction in neurologic injury and disease. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.

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