Treatments For Neurogenic Bladder

Treatment Options For Neurogenic Bladder

Having a neurological condition, such as Multiple Sclerosis or Parkinson’s disease can be overwhelming, both physically and emotionally.  But one thing many people may not realize is how it will affect their bladder. Luckily, there are treatments available that can help to minimize symptoms of neurogenic bladder and allow you to live without the fear of an accident. Today, we’re going to discuss what neurogenic bladder is, and 2 ways you can treat it.  

What Is Neurogenic Bladder? 

Neurogenic bladder affects many Americans and occurs when there is a problem with the way your brain communicates with your bladder. People who have a neurogenic bladder usually experience a bladder that is either overactive (spastic) or underactive (flaccid).

 

What are the symptoms of a neurogenic bladder?

There are many symptoms of a neurogenic bladder. These include: 

  • Incontinence

  • Urinary Tract Infections (UTIs)

  • Frequent urination

  • An urgent need to use the empty the bladder immediately

  • Painful urination

  • The inability to completely empty the bladder

  • A weak urine stream

  • Nocturia, the need to empty the bladder more than once per night

 

What treatment options exist for Neurogenic Bladder?

Luckily, there are many treatment options for Neurogenic Bladder.

Behavioral modifications.

Certain foods and drinks are known bladder irritants and may contribute to an overactive bladder. Try keeping a bladder diary to identify any triggers that may be causing your bladder problems and then work to avoid them. Additionally, maintaining a healthy weight through diet and exercise can help ease pressure placed on the bladder and also strengthen the pelvic floor muscles used to control bladder function. 

Self Catheterization.

Many people with neurogenic bladders use a catheter to control their bladder. A catheter is a thin tube that is inserted into the urethra and then into the bladder to allow urine to drain from the bladder.  While using a catheter may sound a little intimidating at first, most people are able to master the process quickly and it can provide a great deal of freedom for those struggling with bladder control.

Pharmaceutical Options.

There are a number of pharmaceutical options available – both prescription and over the counter. Always talk with your doctor before trying something new.   

Botox Injections.

It’s not just for wrinkles!  Botox is also approved for overactive bladder (spastic bladders). Your doctor will inject botox into the bladder muscle, where it helps to block the nerve signals that trigger OAB, or spastic bladder.  Many people find this reduces leaks and the number of times you need to urinate each day. It also helps with that urgent feeling of needing to empty the bladder. 

Surgery

If all else fails, there are different surgeries available to treat neurogenic bladder.  Bladder augmentation is a surgical procedure to make the bladder larger. This helps reduce the pressure in the bladder, and reduce leaks.

If you’re living with Neurogenic Bladder, talk with your doctor about treatment options. Need help finding a qualified specialist? Try our Doctor Finder!

 

Can MS Cause Incontinence?

Can MS Cause Incontinence?

March is Multiple Sclerosis Awareness Month here in the US and we’re taking a moment to talk about MS and it’s effect on the bladder and bowel.

What is Multiple Sclerosis?

Multiple Sclerosis (MS) happens when the body’s immune system attacks the protective coating around the nerve fibers in the central nervous system (CNS), damaging the nerves. This alters or stops the messages within the CNS and can produce a variety of symptoms in people.

What are the symptoms of MS?  

While symptoms of MS vary from person to person, and even within the same person at different points throughout their lifetime, some of the more common symptoms of MS are fatigue, pain, numbness or tingling, weakness, walking difficulty, vision problems, sexual problems, dizziness and vertigo, bladder and bowel problems, thinking difficulty, emotional changes and depression.1  Luckily, many of these symptoms are treatable with medication.

How does MS affect bladder function?

In a healthy bladder, the nerves in the bladder communicate through the spinal cord to the brain, notifying it that the bladder needs to be emptied. For this process to work smoothly, it requires a coordination between the bladder muscles and the sphincter.

For people with MS, bladder function can be impaired when the signal from the bladder to the brain is delayed or blocked. This can cause the bladder to be either overactive (often referred to as a “spastic” bladder), or under-active, resulting in the inability to empty the bladder completely.  Either of these conditions can lead to a variety of problems, including:

  • Urinary Urgency (The need to urinate frequently and urgently.)

  • Nocturia (Needing to wake to use the bathroom more than one time per night.)

  • Difficulty urinating.

  • Sphincter Dyssynergia A problem where there is both a storage dysfunction and an emptying dysfunction. The bladder is trying to contract and empty, and the urethra contracts instead of relaxing, allowing little or no urine to pass.

  • Under-active Bladder: The nerve signals from the bladder to the brain are damaged and the signal for the bladder to contract and release urine are blocked. This can cause the bladder to eventually overflow and leak urine, or, if the bladder cannot empty completely, results in urinary retention.

In addition to disease related complications, some medications for MS can also cause bladder problems.

How can bladder problems with MS be treated?

Luckily, there are various treatment options that can be used to address bladder problems associated with multiple sclerosis. 

Behavioral modifications, such as avoiding bladder irritating foods and drinks, and bladder retraining can help to manage problems in some people. Pelvic floor physical therapy can also work by strengthening the pelvic floor muscle, providing greater muscle control.

Intermittent self-catheterization, in which a small tube is inserted into the urethra to empty the bladder, can prevent the bladder from overfilling and help prevent urinary infections.

There are many pharmaceutical options available for bladder control. In addition, PTNS, Interstim, and Botox are all in office procedures that can have a positive effect on bladder control for many patients.

Talk to your doctor about your options to find one that works best for you.

References: 1. National MS Society: https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms

The Link Between Diabetes And Neurogenic Bladder

diabetes and neurogenic bladder

Diabetes is a growing epidemic in our nation. More than 29 million Americans currently suffer from diabetes, and the Centers for Disease Control and Prevention estimates that by 2050, as many as 1 out of every 3 adults in the US could have the condition.

Many of us have heard the common complications associated with diabetes: heart disease and stroke, eye problems, including blindness, kidney disease and amputations due to damaged blood vessels and nerves.  But did you know that diabetes can also lead to neurogenic bladder?

Neurogenic bladder is a condition that occurs when nerve damage has occurred, preventing the bladder from emptying properly. Symptoms can include a frequent and strong urge to urinate (but in small amounts), difficulty emptying the bladder, incontinence, and urinary retention. Many people associate neurogenic bladder with conditions such as spinal cord injuries, MS, Alzheimer’s Disease, or Parkinson’s Disease. But neurogenic bladder can happen in people with diabetes too, as a result of diabetic neuropathy, which causes the bladder to lose the ability to sense when it is full.

The good news is that there are treatment options available for neurogenic bladder. Lifestyle changes, such as scheduled voiding, dietary changes, and keeping a bladder diary are a helpful start and can make a big difference.  Several drugs and procedures can help with symptoms of overactive bladder, and for those who have difficulty urinating, catheters can be a big help as well. Finally, surgery options are available. 

Of course, if you are pre-diabetic, the best course of treatment is prevention. Keeping your A1C levels in check with proper diet and exercise is essential in ensuring that you maintain a healthy weight.  Eating healthy foods at moderate portions, and getting in 30 minutes of physical activity can delay and in some cases prevent the disease.

If you are concerned about diabetes, talk with your doctor. He or she will help you assess your risk factors, and start you on a plan to combat this very prevalent disease.

Ask The Expert: What's The Best Way To Prevent UTI's When You Have A Neurogenic Bladder?

UTI's and neurogenic bladder

Question:  What’s the best way to prevent UTI’s when you have a neurogenic bladder?

Answer:  Unfortunately, Urinary Tract Infections are common in patients with neurogenic bladder. Patients with neurogenic bladder often have a harder time completely emptying their bladder. They also are often unable to sense that the bladder is full, resulting in them holding urine for too long.  Some patients also self catheterize, or use indwelling catheters, which can present complications leading to a UTI.

Of course, the best treatment of a UTI is prevention. 

Below are 2 simple steps that patients living with neurogenic bladders can take to avoid bladder infections.

1. Keep things clean.

It stands to reason that keeping yourself, and any equipment used to assist with voiding, hygienic can help keep bacteria at bay. Be sure to properly clean your body, and any external catheters after each use. Always wash hands before and after self-catheterizing.  During a short-term infection, change indwelling catheters and be sure that the bladder fully empties to prevent urine from remaining in the bladder for too long.

2. Develop a voiding schedule.

While many things are considered when deciding when to catheterize, including patient and caregiver schedules and urine production, steps should be taken to ensure that the bladder is emptied frequently to prevent infections. Develop a schedule that works for you and stick to it.

UTI’s can cause many complications for people with Neurogenic Bladder, including decreased quality of life and other serious health concerns. If you are experiencing any common signs of a UTI, call your doctor.

Common signs of a UTI:

  • Fever
  • Urinary incontinence/leaking around the catheter
  • Cloudy urine
  • Spasticity
  • Back pain
  • Bladder pain
  • Lethargy
  • Painful or difficult urination
  • Sudden, high blood pressure

What Is Neurogenic Bladder?

What Is Neurogenic Bladder?

Having a neurological condition presents many challenges, but one that few people likely think about until they are dealing with it is how the condition may affect your ability to use the restroom. Like many organs, the bladder is controlled by nerves that connect to your brain and spinal cord. When these functions are challenged due to a neurological condition, it can cause a person to have a neurogenic bladder.

What is Neurogenic Bladder?

Neurogenic bladder happens when there is a lack of bladder control due to a brain, spinal cord or nerve problem. Typically, the bladder has two functions – storing urine, and removing it from the body. These functions are controlled by communication in the spinal cord and brain. When a person’s nerves, brain or spinal cord become injured, the way they communicate with the bladder can become compromised.

There are two types of neurogenic bladder: the bladder can become overactive (spastic or hyper-reflexive), or under-active (flaccid or hypotonic).

With an overactive bladder, patients experience strong and frequent urges to use the bathroom, and sometimes have trouble making it in time, resulting in urinary incontinence.

In an under-active bladder, the sphincter muscles may not work correctly and may stay tight when you are trying to empty your bladder, resulting in urinary retention (producing only a small amount of urine) or obstructive bladder (when you are unable to empty your bladder at all). In either case, treatment is available.

What Causes Neurogenic Bladder?

Neurogenic bladder can be caused by a number of conditions. Some children are born with neurogenic bladder. Children born with spina bifida (when the fetus’ spine does not completely develop during the first month of pregnancy), sacral agenesis (when lower parts of the spine are missing), or cerebral palsy (a disorder that weakens a person’s ability to control body movement and posture) all may suffer from neurogenic bladder due to their conditions. Other medical conditions that may cause neurogenic bladder are Parkinson’s disease, Multiple Sclerosis (MS), spinal cord injury, stroke, or central nervous system tumors.

What Are The Treatment Options For Neurogenic Bladder?

Luckily, there are many treatment options for neurogenic bladder. Treatments vary depending on whether you have overactive bladder or urinary retention. To learn about treatments for these conditions, click through the links below.

Treatments for Overactive Bladder

Treatments for Urinary Retention

A neurogenic bladder doesn’t have to limit your life. Don’t be afraid to explore your options and find a treatment that works for you.

Do you have a neurogenic bladder? Tell us about your experience in the comments below – we’d love to hear about treatment options that have worked for you!

Pelvic Floor Disorders Are Common Among Patients With Multiple Sclerosis

Pelvic Floor Disorders And Multiple Sclerosis

Multiple Sclerosis (MS) is the most common autoimmune disease presently affecting approximately 2 million people worldwide. 

MS is a disease of the central nervous system. The central nervous system is the hub for the autonomic nervous system and the somatic nervous system. These systems regulate many parts of your body’s mechanics. Most notably: blood pressure, heart rate, bowel activity, sexual arousal, skin sensation, and muscle control.  

In patients with MS the immune system attacks the material that insulates nerve fibers. Without insulation the nerves of the central nervous system cannot communicate with the rest of the body.  This faulty communication between the brain and spinal cord often results in muscle weakness, abnormal sensation, psychiatric problems, and difficulty regulating breathing, blood pressure, and temperature.  Loss of bladder or bowel control can be a result of muscle weakness; almost half of MS patients report bladder and or bowel complaints as the first symptoms of multiple sclerosis.

Sixty-eight percent of individuals with MS experience symptoms of one or more Pelvic Floor Disorders (PFD). PDFs are a loss or lack of bladder or bowel control and can include urinary incontinence, urinary frequency and urgency, bowel incontinence, sexual dysfunction, pelvic organ prolapse, and pelvic pain related to a “spastic” pelvic floor.

Among MS patients with PFDs the most common diagnosis are overactive bladder (69%), voiding problems (41%), Sexual dysfunction (42%), and fecal incontinence (30%)[i].  These symptoms represent major detriments to quality of life. 

The good news is that patients with MS can benefit from the same behavior modifications as anyone else with a pelvic floor disorder. Pelvic floor neuromuscular rehabilitation, often referred to as “pelvic floor therapy”, is a behavior modification practice of retraining the pelvic floor muscles using techniques like pelvic floor muscle training, biofeedback therapy and electrical stimulation. 

Modern methods of pelvic floor rehabilitation such as The Pfilates Method™ and The VESy Lab™ utilize movement taken from Pilates and Yoga to provide greater pelvic floor response.  The key to success with pelvic floor rehabilitation is establishing a practice that continues for a lifetime.  Working with a specially trained Physical Therapist provides excellent results and should be considered an element of any care plan for MS patients with bothersome pelvic floor symptoms.

[i] Int J MS Care. 2014 Spring;16(1):20-5. doi: 10.7224/1537-2073.2012-052.

Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.
Dr. Bruce Crawford is Dr. Bruce Crawford is a Board Certified Urogynecologist and the creator of the PfilatesTM program of pelvic floor rehabilitation. He has personally trained over 1,500 physical therapists and fitness professionals in North America, Asia, and the UK. Dr. Crawford also originated the VESy LabTM Method of optimizing pelvic floor fitness training.