What Is the Pathophysiology of Neurogenic Bladder?

The pathophysiology of neurogenic bladder refers to the dysfunction of the bladder caused by damage to the central nervous system. Common diseases and injuries to the central nervous system that can cause neurogenic bladder include Alzheimer's disease, multiple sclerosis, brain tumors and spinal cord damage. Treatment of neurogenic bladder can involve medication, catheterization and surgery.

Definition

• Neurogenic bladder is a urinary bladder that malfunctions in some way due to a neurological disorder. A neurological disorder is damage to the central nervous system, which consists of the brain and spinal cord. Among its other functions, the central nervous system controls the urinary system and a person's ability to control urination. Diseases and injuries that compromise the central nervous system can result in the loss of control over the urinary system.

Symptoms

• According to Medline Plus, symptoms of neurogenic bladder vary depending on the underlying neurological disorder. The two main categories of symptoms are overactive bladder and underactive bladder. Overactive bladder can involve frequent need to urinate and incomplete emptying of the bladder. Symptoms of an underactive bladder include not being able to tell when the bladder is full and difficulty urinating.

Physiology

• The physiology of the bladder refers to normal bladder functioning. The two basic functions of the bladder are filling and emptying. According to Medscape.com, most people will urinate four to eight times a day, which means that the bladder is filling, or in "storage mode," most of the time. Communication between the brain and the muscles that control the bladder regulate urination.

Pathophysiology

• While physiology of the bladder concerns normal bladder functioning, the pathophysiology of neurogenic bladder refers to dysfunction of the bladder. The pathophysiology of neurogenic bladder can involve a number of diseases and injuries that affect the central nervous system. Stroke, brain tumors, Parkinson's disease and cerebral palsy are examples of brain damage, or brain lesions, that can cause a person to lose control of the urinary system. People with such brain lesions may have overactive bladders and have to urinate frequently, and they may not be able to control when and where they urinate. Damage to the spinal cord caused by a physical injury or multiple sclerosis can also cause urinary incontinence and an overactive bladder. AIDS, herniated discs, tumors on the sacral cord and a crushed pelvis can cause a person to be unaware that his or her bladder is full, and he may also experience difficulty urinating.

Treatment

• Certain medications exist to help control the symptoms of neurogenic bladder. Oxybutynin and propantheline are drugs used to treat overactive bladders, and bethanechol is a drug used to increase bladder activity. Some cases of neurogenic bladder may require that a catheter be placed in the bladder, and still other cases may require surgery.