Neurogenic Bladder
Bladder dysfunction in women from neurological causes where altered innervation leads to storage and voiding dysfunction, often masking co-existing urothelial conditions.
Overview
Neurogenic Bladder results from neurological damage to the pathways controlling bladder function — from spinal cord injury, multiple sclerosis, Parkinson's disease, or pelvic nerve damage. The bladder may be overactive (spastic) or underactive (flaccid). Co-existing GAG layer dysfunction is frequently overlooked, worsening symptoms beyond what neurological damage alone explains.
Key Symptoms
- Urgency incontinence or overflow incontinence
- Incomplete bladder emptying
- Urinary retention or frequency
- Loss of coordinated voiding
- Recurrent UTIs from incomplete emptying and catheter use
Pathophysiology
Disrupted sacral and supraspinal neural circuits alter detrusor compliance and external sphincter coordination. Chronic catheter use and incomplete emptying compromise the GAG layer, creating secondary urothelial vulnerability.
Treatment Approach
Antimuscarinics or beta-3 agonists for overactivity, clean intermittent catheterisation, botulinum toxin injections, and intravesical PPS for concurrent GAG layer support.