Neurogenic bladder is a medical condition caused by nerve damage or dysfunction that affects the bladder's ability to store or empty urine properly. The condition arises when the communication between the brain, spinal cord, and bladder is disrupted due to an underlying medical issue.

The bladder relies on smooth coordination between its muscles, sphincters, and nerves to function correctly. When this intricate system is compromised, it can lead to either overactive bladder function or difficulty emptying the bladder—both of which fall under the umbrella of neurogenic bladder.

The symptoms of neurogenic bladder depend on whether the bladder's function is underactive or overactive due to nerve damage. Patients may experience varying degrees of difficulty, which can significantly impact their daily lives.

Common Symptoms Include:

• Overactive Bladder: This is characterised by frequent urges to urinate, even when the bladder is not full. Common symptoms include:

• Urinary urgency

• Frequent urination, often in small amounts

• Nocturia (needing to urinate frequently during the night)

• Underactive Bladder: This occurs when the bladder does not empty completely. Symptoms may include:

• Difficulty starting urination

• Weak urine stream or dribbling

• Sensation of a full bladder even after urinating

• Recurrent urinary tract infections (UTIs)

For both overactive and underactive bladder types, there is a risk of complications, such as bladder infections, kidney damage, or incontinence.

Diagnosing neurogenic bladder requires a thorough medical evaluation by a healthcare professional, often involving a urologist or neurologist.

Managing Neurogenic Bladder

Neurogenic bladder treatment requires a tailored approach to improve bladder function, protect kidney health, and enhance quality of life. At our urology practice in Melbourne, we provide evidence-based therapies guided by a specialist urologist to address each patient’s unique needs. The right treatment depends on the type and severity of bladder dysfunction, underlying cause, and individual lifestyle factors.

1. Lifestyle Modifications

For some people, small daily adjustments can significantly reduce bladder symptoms:

• Bladder Training: Scheduled visits to retrain the bladder to hold urine longer.

• Fluid Management: Balancing hydration while avoiding excessive bladder filling.

• Dietary Adjustments: Reducing caffeine, alcohol, and artificial sweeteners that can irritate the bladder.

2. Medications

Medications are often the first step in bladder dysfunction management:

• Anticholinergics: Relax overactive bladder muscles to reduce urgency.

• Beta-3 Adrenergic Agonists: Increase bladder storage and reduce frequency.

• Alpha-Blockers: Assist with easier bladder emptying in underactive bladder.

• Antibiotics: Used when recurrent urinary tract infections occur from incomplete emptying.

3. Catheterisation

When the bladder cannot empty on its own, catheterisation may be recommended:

• Intermittent Catheterisation: Regular self-catheterisation to prevent retention.

• Indwelling Catheters: A longer-term option for selected patients.
  Our Melbourne urology team provides guidance to ensure safe use and reduce infection risk.

4. Botulinum Toxin (Botox) Therapy

For patients with overactive bladder not responding to standard medication, Botox injections can relax bladder muscles, reduce spasms, and improve continence.

5. Neuromodulation Therapy

Neuromodulation uses gentle electrical impulses to stimulate bladder-controlling nerves. Options include:

• Sacral Nerve Stimulation

• Percutaneous Tibial Nerve Stimulation

These therapies can be highly effective for urgency, frequency, and incontinence.

6. Surgical Options

When other treatments are unsuccessful, surgery may be considered for severe neurogenic bladder:

• Bladder Augmentation: Enlarging the bladder using bowel tissue to improve capacity.

• Urinary Diversion: Creating a new pathway for urine when bladder function cannot be restored.

Neurogenic Bladder Treatment in Melbourne

Managing neurogenic bladder is rarely a one-size-fits-all process. Many patients benefit from a combination of therapies tailored to their needs. Seeing a specialist urologist in Melbourne ensures comprehensive assessment, access to advanced treatments, and ongoing care to preserve kidney health and improve quality of life.

If you are experiencing symptoms of bladder dysfunction, book a consultation with Dr. Deanne Soares, Melbourne urologist, to discuss personalised treatment options.