What are the causes of neurogenic bladder?

From the Guidelines

Neurogenic bladder is primarily caused by damage to the nervous system, which disrupts normal bladder function, and can result from various conditions such as spinal cord injuries, multiple sclerosis, diabetes mellitus, and stroke. The most common causes of neurogenic bladder include:

• Spinal cord injuries, which interrupt nerve signals between the brain and bladder 1
• Multiple sclerosis, where demyelination affects nerve transmission 1
• Diabetes mellitus, which can lead to peripheral neuropathy affecting bladder innervation 1
• Stroke, which damages brain centers controlling urination 1 Other significant causes include:
• Parkinson's disease, which affects autonomic function 1
• Spina bifida, a congenital neural tube defect
• Various tumors that compress nerves controlling the bladder Certain surgeries, particularly those involving the pelvis or lower spine, can damage relevant nerves. Infections like transverse myelitis or Guillain-Barré syndrome can cause temporary or permanent neurogenic bladder. The specific presentation depends on which part of the nervous system is affected - damage to upper motor neurons (above the sacral spinal cord) typically causes spastic bladder with urinary urgency and frequency, while damage to lower motor neurons results in flaccid bladder with overflow incontinence. Treatment approaches vary based on the underlying cause and specific bladder dysfunction pattern, ranging from medications like anticholinergics or alpha-blockers to catheterization techniques or surgical interventions.

From the Research

Causes of Neurogenic Bladder

The causes of neurogenic bladder can be attributed to various factors, including:

• Damage to the brain, spinal cord, or nerves that control bladder function 2
• Neurologic disorders such as multiple sclerosis, Parkinson's disease, spinal cord injury, and spina bifida 3
• Lesions of the central nervous system 4
• Spinal cord injury (SCI) which can lead to loss of supraspinal coordination and unabated reflexes in both autonomic and somatic nervous systems 5

Associated Conditions

Neurogenic bladder can be associated with various conditions, including:

• Urinary incontinence, frequency, and urgency 3
• Risk of infection and involvement of the upper urinary tract and kidney disease 3
• Upper urinary tract damage 2
• Autonomic dysreflexia 5
• Vesicoureteral reflux, urinary tract infections, and calculi associated with neurogenic lower urinary tract dysfunction (NLUTD) 5

Management and Complications

The management of neurogenic bladder is crucial to prevent severe complications, including:

• Renal damage 6, 4
• Social isolation due to embarrassment resulting from urinary incontinence 3
• Excessive healthcare utilization, including office and emergency department visits and subsequent hospitalizations 3