Neurogenic bladder refers to dysfunction of the urinary bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 due to disease of the central nervous system

Central nervous system

The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

 or peripheral nerves involved in the control of micturition (urination).

Causes

Neurogenic bladder is often associated with spinal cord diseases (such as Syringomyelia

Syringomyelia

Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, and...

/Hydromyelia), injuries, and neural tube defects including spina bifida

Spina bifida

Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...

. It may also be caused by brain tumor

Brain tumor

A brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.Brain tumors include all tumors inside the cranium or in the central spinal canal...

s and other diseases of the brain

Brain

The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

, and by peripheral nerve diseases

Peripheral nervous system

The peripheral nervous system consists of the nerves and ganglia outside of the brain and spinal cord. The main function of the PNS is to connect the central nervous system to the limbs and organs. Unlike the CNS, the PNS is not protected by the bone of spine and skull, or by the blood–brain...

. It is a common complication of major surgery in the pelvis, such as for removal of sacrococcygeal teratoma

Sacrococcygeal teratoma

Sacrococcygeal teratoma is a teratoma located at the base of the coccyx . It is thought to be a derivative of the primitive streak.-Natural history:...

 and other tumors.

Treatments

Neurogenic bladder usually causes difficulty or full inability to pass urine without use of a catheter or other method. Catheterization methods range from intermittent catheterization, which involves no surgery or permanenty attached appliances, to the creation of a stoma, which bypasses the urethra to empty the bladder directly.

Intermittent catheterization is the use, several times a day, of straight catheters (which are usually disposable or single-use products) to empty the bladder. This can be done independently by the patient, or with help, in the case that the patient lacks the dexterity to manage the catheter.

Other treatments involve creation of a stoma

Stoma (medicine)

A stoma is an opening , either natural or surgically created, which connects a portion of the body cavity to the outside environment...

 that is continent and readily accepts a catheter. These are known as Mitrofanoff

Mitrofanoff appendicovesicostomy

Mitrofanoff appendicovesicostomy, also known as the Mitrofanoff procedure, is a surgical procedure in which the appendix is used to create a conduit between the skin surface and the urinary bladder.-Description of procedure:...

 mechanisms. An example of this treatment is the creation of an Indiana pouch

Indiana pouch

An Indiana pouch is a surgically-created urinary diversion used to create a way for the body to store and eliminate urine for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital,...

. Additionally, a muscarinic agonist like Bethanechol

Bethanechol

Bethanechol is a parasympathomimetic choline carbamate that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not hydrolyzed by cholinesterase and will therefore have a long duration of action. Bethanechol does not involve...

 may also be used, particularly in the postpartum or postoperative period.

Function of the stoma may be augmented by periodic injections of botulinum toxin

Botulinum toxin

Botulinum toxin is a protein produced by the bacterium Clostridium botulinum, and is considered the most powerful neurotoxin ever discovered. Botulinum toxin causes Botulism poisoning, a serious and life-threatening illness in humans and animals...

to relax one of the two sphincters involved in normal urination. The effect is longer lasting with botulinum toxin type A than with type B. This use of botulinum toxin is discussed at length in the French medical literature.