•refers to dysfunction of the urinary bladder
due to disease of the central nervous
system or peripheral nerves involved in the
control of micturition (urination).
•A flaccid, or hypotonic, bladder ceases to contract
fully, causing urine to dribble out of the body. Besides
the complications that stem from urine dripping,
rashes can occur in the area where urine pools. This
type of bladder disorder occurs when the volume of
urine is large but the pressure is low.
•A spastic, or reflex, bladder occurs when
the volume of urine is normal or small, but
there are involuntary contractions, causing
a person to feel the need to urinate even
when he doesn't need to release urine
Causes of Neurogenic
•Spina bifida and neural
disorders resulting from diabetes
Nerve damage may
•Brain or spinal cord injury
•Heavy metal poisoning, or tumors of the
brain, spinal cord or pelvis
Symptoms of Neurogenic Bladder
•Overactive bladder .
•Frequent urination, in the daytime and at night
•Inability to urinate (urinary retention)
•Underactive bladder – bladder is unable to signal
Etiology And Risk Factors
•Trauma to the nervous system
•Retention with or without incontinence
•The client may or may not feel a need to
void or feel a sense of bladder distension.
•Overflow Incontinence related to chronically overfilled bladder with
loss of sensation of bladder distention.
•Overflow Incontinence related to detrusor-sphincter dyssynergy
•Reflex Incontinence related to absence of sensation to void and loss
of ability to inhibit bladder contraction.
•High Risk for Infection related to retention of urine or introduction of
•Urge Incontinence related to inability to inhibit urination after urge is
•High risk for Loneliness related to embarrassment from incontinence
in front of others and fear of odor from urine
•Medicines that relax the bladder (oxybutynin,
tolterodine, or propantheline)
•Medicines that make certain nerves more active
•Botulinum toxin (Botox)
Your doctor may refer you someone who has been trained to
help people manage bladder problems. Skills or techniques you
may learn include:
•Exercises to strengthen your pelvic floor muscles (Kegel
•Keeping a diary of when you urinate, the amount you urinated,
and if you leaked urine. This may help you learn when you
should empty your bladder and when it may be best to be near
Sometimes surgery is needed. Surgeries for neurogenic
•Electrical device implanted near the bladder nerves, to
stimulate the bladder muscles
•Creation of an opening (stoma) in which urine flows into a
special pouch (this is called urinary diversion
LESIONS AT OR BELOW S2/S4
INTERRUPTED AFFERENT SIGNALS BELOW S2/S4
LOW OF SENSATION OF BLADDER FILLING
POOR CONTRACTION OF
BLADDER CAPACITY (2000ML)
BLADDER PRESSURE REACHES A
BREAK THROUGH POINT
SMALL AMOUNTS OF URINE DRIBBLE
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