Neurogenic bladder is a dysfunction of the urinary bladder caused by disease of the central nervous system or peripheral nerves that control urination. There are two main types: a flaccid bladder that does not contract fully and leaks urine, and a spastic bladder that has involuntary contractions causing frequent urination. Causes include stroke, Parkinson's disease, MS, spinal cord injuries, and more. Symptoms include frequent urination, incontinence, and inability to urinate. Treatment options include medications to relax or stimulate the bladder, botulinum toxin injections, surgery like an artificial sphincter or urinary diversion with a stoma.

1. Mr. Mahesh Chand
Tutor

2. DEFINITION
•refers to dysfunction of the urinary
bladder due to disease of the central
nervous system or peripheral nerves
involved in the control of micturition
(urination).

5. FLACCID BLADDER
•A flaccid, or hypotonic, bladder ceases to contract
fully, causing urine to dribble out of the body. Besides
the complications that stem from urine dripping,
rashes can occur in the area where urine pools. This
type of bladder disorder occurs when the volume of
urine is large but the pressure is low.

6. Spastic Bladder:
•A spastic, or reflex, bladder occurs when
the volume of urine is normal or small, but
there are involuntary contractions, causing
a person to feel the need to urinate even
when he doesn't need to release urine

7. Causes of Neurogenic
Bladder
•Stroke
•Parkinson’s disease
•Multiple sclerosis
•Alzheimer’s disease
• Spina bifida and neural
disorders resulting from diabetes
or alcoholism

8. Nerve damage may result
from:
•Child birth
•Pelvic injury
•Brain or spinal cord injury
•Herniated disc
•Heavy metal poisoning, or tumors of the
brain, spinal cord or pelvis

9. Symptoms of Neurogenic Bladder
•Overactive bladder .
•Frequent urination, in the daytime and at night
(nocturia)
•Stress incontinence
•Urge incontinence
•Inability to urinate (urinary retention)
•Underactive bladder – bladder is unable to signal
when full

10. Etiology And Risk Factors
•Tumors
•Neurologic disorders
•Trauma to the nervous system
Clinical Manifestation
•Retention with or without incontinence
•The client may or may not feel a need to
void or feel a sense of bladder
distension.

11. NURSING DIAGNOSIS
•Overflow Incontinence related to chronically overfilled
bladder with loss of sensation of bladder distention.
•Reflex Incontinence related to absence of sensation to void and
loss of ability to inhibit bladder contraction.
•High Risk for Infection related to retention of urine or
introduction of urinary catheter.
•Urge Incontinence related to inability to inhibit urination after
urge is perceived.
•High risk for Loneliness related to embarrassment from
incontinence in front of others and fear of odor from urine

12. Treatment
•Medicines that relax the bladder (oxybutynin,
tolterodine, or propantheline)
•Medicines that make certain nerves more active
(bethanechol)
•Botulinum toxin (Botox)
•GABA supplements
•Antiepileptic durgs

13. Your doctor may refer you someone who has been trained to
help people manage bladder problems. Skills or techniques you
may learn include:
•Exercises to strengthen your pelvic floor muscles (Kegel
exercises)
•Keeping a diary of when you urinate, the amount you urinated,
and if you leaked urine. This may help you learn when you
should empty your bladder and when it may be best to be near
a bathroom.

14. Sometimes surgery is needed. Surgeries for neurogenic
bladder include:
•Artificial sphincter
•Electrical device implanted near the bladder nerves, to
stimulate the bladder muscles
•Creation of an opening (stoma) in which urine flows into a
special pouch (this is called urinary diversion