Neurogenic Bladder. When there are nerve root problems, the transmission of the message sent from the brain down the spinal cord and to the bladder is interrupted. This causes dysfunction of the bladder and is referred to as Neurogenic bladder. In Neurogenic bladder , several problems may occur.

Overflow incontinence occurs when the nerves that control normal urination are affected, causing the bladder to fill and overflow without warning.

Storage Dysfunction causes the detruser muscle of the bladder to become overly active. Contractions of the bladder occur even though a small amount of urine has collected The sphincter opens, resulting in urgency and frequency. In more severe cases, involuntary urination occurs.

Urge incontinence occurs when the signal to the bladder makes the nerves to the bladder supersensitive, causing the urge to be so strong that there is urine loss before you reach the bathroom. The urge to urinate more than every three or four hours is abnormal. When there is a need to urinate one or more times a night it is called nocturia.

Nocturia incontinence is when urine is lost during sleep.

Reflex incontinence occurs when the message does not get to the bladder and it empties without warning.

Urinary hesitancy is when there is difficulty in initiating the flow of urine. Emptying dysfunction occurs when the sphincter is spastic or tight.

Overflow incontinence. When the urine overflows because the bladder is too full. There may be "leaking" or "dribbling".

Incomplete emptying sensation is caused when some of the urine remains in the bladder after urination. This urine is called "residual urine". A contracted or tight sphincter blocks the exit and bacteria grows in the stagnant urine, which backs up in the ureters. Long standing urine in the bladder under high pressure gives rise to back up of urine (hydronephrosis) which can cause permanent kidney damage. Temporary high pressure during voiding can overcome the valves that direct urine flow from the kidneys and cause reflux.

When combinded with infection, reflux can greatly destroy the kidneys.Diseases such as Arachnoiditis may cause a combination of storage and emptying problems called combined dysfunction.

Symptoms result from both an excessively active bladder and sphincter blockage due to spasms. This may include: urgency, frequency, nocturia, incontinence, hesitancy, sensation of complete bladder emptying, urinary tract infections, or kidney damage.

DISCLAIMER

This information must not be treated as a medical diagnosis but it is for medical information ONLY. If you suspect you may have any of the conditions listed PLEASE CONTACT YOUR DOCTOR IMMEDIATELY.

The Back Pain Association of America acknowledges with appreciation Dr. Jacek Mostwin, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, for his generous contribution in the preparation of this fact sheet.