Managing Neurogenic Bladder

Neurogenic Lower Urinary Tract Dysfunction (NLUTD), or neurogenic bladder, arises from nerve damage affecting bladder control due to disease or injury. Symptoms vary based on the location and extent of neurological damage and may present as overactive or underactive bladder, detrusor sphincter dyssynergia (DSD), or combinations thereof. While NLUTD cannot be cured, various treatments can help manage symptoms, prevent complications such as urinary tract infections and kidney damage, and support a fuller quality of life. Management strategies are tailored to individual symptoms and needs.

Non-invasive options include lifestyle changes like timed or double voiding, dietary adjustments, and pelvic floor therapy. Pharmacologic treatments involve oral medications or BOTOX® injections to relax the bladder. Catheterization—intermittent or indwelling—is commonly used to empty the bladder and can be performed through the urethra or a surgically created stoma. Surgical treatments may include bladder augmentation, urinary diversion, sphincterotomy, or implantation of an artificial sphincter. Treatment plans depend on the specific type of NLUTD: overactive, underactive, mixed, or DSD. The goal is to ensure bladder safety, independence, and improved quality of life. Medical professionals, especially urologists, play a key role in selecting the most appropriate interventions for each individual.

Rehabilitation Research and Training Center on Health and Function of People with Physical Disabilities. (2020). Managing NLUTD. MedStar National Rehabilitation Hospital. https://www.spinabifidaassociation.org/wp-content/uploads/Managing-NLUTD-Factsheet_2022_05_d2-FINAL.pdf