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If doctors diagnose your child with neurogenic bladder, it means that he or she doesn't have full bladder control because of a brain, spinal cord or nerve problem. It affects people differently.
Certain factors increase a child's chance of having neurogenic bladder. They include:
- A birth defect that affects the spinal cord, such as spina bifida
- A spinal cord injury
- A brain tumor or spinal cord tumor near the pelvis
- Infection of the brain or spinal cord
Damage or injury to nerves that carry signals between the bladder and the brain cause neurogenic bladder.
Several muscles and nerves must coordinate to help a child's bladder hold urine until he or she is ready to empty the bladder. If some of these nerves are damaged, the muscles may not be able to tighten or relax at the appropriate time.
In some cases, the bladder may not fill or empty correctly.
Symptoms may include:
- Urine leakage, or urine coming out without control
- Inability to urinate or urinating small amounts (urine retention)
- Frequent urination
- Inability to feel the bladder is full or when urine is leaking out (no sensation)
- Repeated urinary tract infections
- Kidney injury or refluxing back up to the kidneys
Other conditions can cause some of these symptoms. If your child has any of these symptoms, talk to his or her doctor.
A doctor will ask parents about their child's symptoms and medical history and may request that parents keep a diary of how often their child empties his or her bladder. The doctor will also perform a physical exam on the child.
Your child's medical team may perform a range of tests, including those that examine urine, blood and bladder function. Experts may perform imaging tests to evaluate the bladder and urinary tract.
Experts may also perform a special test called urodynamics. This test checks how well a child's lower urinary tract stores and releases urine. In one such test, a catheter – a thin hollow tube about the size of a pencil lead – will be inserted into the child's bladder to drain the bladder and then water or a special dye will be used to fill up the bladder and check the resulting pressure.
Treatment for neurogenic bladder varies based on the cause of the child's nerve damage and the type and severity of symptoms, among other factors.
Treatment might include:
- Timed voiding, or having the child use a toilet at scheduled times. This can avoid accidents, as well as prevent urinary tract infections and damage to the kidneys.
- Use of a catheter, inserted into the child's urethra and up into the bladder, to periodically empty the bladder. In some cases, a more permanent bladder called an indwelling catheter might be needed.
- Medications, which can help relax the bladder muscles, prevent muscle spasms and improve bladder function. A physician might also prescribe antibiotics to reduce the chance of urinary tract infections.
If other treatments fail, surgery might be an option; the type of surgery depends on the cause of the problems. One example is what is called a bladder augmentation. This is a procedure that makes a child's bladder larger.
The long-term outlook is positive if the condition is diagnosed and treated before kidneys are damaged. But the condition can have a significant impact on children and families.
We're here to help.
If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices.