Neurogenic Bladder
What is Neurogenic Bladder?
Neurogenic bladder (NGB) refers to any condition where there is an abnormality of neurologic function (muscle contraction/relaxation and sensation), which affects the ability of the bladder to store or release urine.
Neurogenic bladder has many causes including;
Brain related conditions: Cerebral palsy, stroke, trauma, tumours.
Spinal cord conditions: Trauma, tumours, spinal bifida, demyelinating conditions
Muscular/bladder conditions: Posterior urethral valve (which presents with a distinct type of bladder dysfunction, and isn’t truly due to abnormality of the nerves)
Idiopathic: Non neurogenic neurgenic bladder, or Hinman syndrome, where no neurologic abnormality is found, but the bladder is severely dysfunctional.
Symptoms of neurogenic bladder are highly variable, and include;
Urinary frequency or urgency
Incontinence
Hesitancy, intermittence (difficulty initiating the passage of urine, or a stream that stops and starts)
Urinary retention (the inability to pass urine at all)
Constipation is commonly associated with NGB
GOALS OF CARE
Protect the kidneys from damage and failure
Attain or preserve urinary continence
Support a good quality of life
DR ROB’S APPROACH
Dr Rob is a specialist in the disorders of bladder and kidney function. If your child is suspected to have a neurogenic bladder, you will be offered a longer appointment to allow for a comprehensive history, examination and review of any investigations.
It is common to need multiple additional investigations to diagnose and monitor neurogenic bladder and it’s underlying causes. This may include bladder/bowel diary, multiple kidney and bladder ultrasounds, MRI, Nuclear scans, urine analysis and blood tests.
There are several highly specialised tests that are very specific to neurogenic bladder including uroflowmetry (measuring the way the bladder empties), and urodynamic studies (measuring the way the bladder pressure changes as the bladder fills).
The treatment of neurogenic bladder may involve physical therapy, medications, intermittent or indwelling catheters, and surgical reconstruction.
If your child has a neurogenic bladder, then in addition to Dr Rob their care will require a multidisciplinary team involving paediatricians, physiotherapists, occupational therapists, continence and stoma nursing, and possibly other surgical specialists such as a neurosurgeon, depending on the underlying cause of NGB.
Neurogenic bladder is an uncommon but serious condition that Dr Rob is highly specialised in the management of, and would be very delighted to meet you and your child to support you in the diagnosis and management.
DR ROB McCUSKER
Gold Coast Children’s Surgeon
Dr Rob is dedicated to the highest quality of care and technical excellence for his patients.