This document discusses neurogenic bladder, which refers to bladder dysfunction caused by diseases of the central or peripheral nervous system. There are two main types: a flaccid bladder that does not contract fully, causing urine to drip out continuously and potentially cause rashes, and a spastic bladder that has involuntary contractions causing frequent urges to urinate. Causes include conditions like stroke, Parkinson's, and spinal cord injuries. Symptoms are things like frequent urination, incontinence, and urine retention. Treatment options include medications to relax or stimulate the bladder, botulinum toxin injections, exercises, and sometimes surgery.

2. NEUROGENIC BLADDER
PRESENTER
DR. MUHAMMAD HUSNAIN

3. ANATOMY OF BLADDER

4. DEFINITION:
“Neurogenic bladder refers to dysfunction of the
urinary bladder due to disease of the central
nervous system or peripheral nerves involved in the
control of micturition.”

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 tube defects
 Disorders resulting from diabetes
 Alcoholism

8. Nerve damage may result from:
 Child birth
 Pelvic injury
 Brain or spinal cord injury
 Herniated disc
 Heavy metal poisoning
 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 Manifestations
 Retention with or without incontinence
 The patient may or may not feel a need to void or feel a
sense of bladder distension.

11. 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
 Exercises to strengthen your pelvic floor muscles (Kegel
exercises)

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

13. SPASTIC NEUROGENIC BLADDER

14. FLACCID NEUROGENIC BLADDER