What Is Neurogenic Bladder in Children?

Neurogenic Bladder

The bladder has two main functions, made possible by the coordinated work of nerves and muscle tissue: storing urine and emptying it. In neurogenic bladder, this coordination and balance are disrupted. There are problems both in transmitting the bladder's fullness signals to the brain through the nerves and in emptying the bladder.

What Causes Neurogenic Bladder?

It may be due to a congenital defect, or it may be caused by spina bifida, spinal cord injury, central nervous system diseases and pelvic tumors.

What Are the Symptoms of Neurogenic Bladder?

• They may vary depending on the underlying cause and other accompanying problems. In most cases, the following are seen:
• Urinary leakage,
• Urinary retention (excessive accumulation of urine in the bladder),
• Hydronephrosis (excessive swelling of the kidney due to urine backing up),
• Vesicoureteral reflux (backflow of urine from the bladder into the ureter),
• Urinary tract infection,
• Kidney stones.

How Is Neurogenic Bladder Diagnosed?

The following studies are performed to diagnose the disease and determine its level.

• Video urodynamic study,
• Kidney and bladder ultrasound,
• Voiding cystourethrogram
• Spinal MRI,
• Blood and urine tests

What Are the Treatment Approaches for Neurogenic Bladder?

The aim of treatment is to protect kidney function, prevent urinary leakage and help the child develop a positive sense of self-confidence. For this purpose, treatment for the child and family is planned with a multidisciplinary approach in which a doctor, nurse and psychologist work together. Treatment can be divided into two groups: medical and surgical.

Medical Approach

• Clean intermittent bladder catheterization: the aim is to prevent urinary tract infection and hydronephrosis by emptying the bladder regularly.
• Overnight catheter use,
• Preventive antibiotic treatment,
• Anticholinergic medication are other treatment options.

Surgical approach

• Vesicostomy: a temporary opening of the bladder onto the lower abdominal wall through a small incision, allowing urine to drain regularly.
• Bladder augmentation
• Appendicovesicostomy
• Cecostomy