Children's Hospital Colorado

Neurogenic Bladder in Children

What is neurogenic bladder?

In order for the bladder to work properly, the muscles and nerves of the bladder must work together. Nerves carry signals to and from the bladder and these signals control how the bladder works. If the nerves are damaged, then the bladder can become neurogenic. The damage can cause the bladder to empty too quickly or too frequently, or it cannot empty completely. Both can lead to children having urinary tract infections, daytime and nighttime wetting (incontinence), and can cause long term kidney damage.

What causes neurogenic bladder?

If a child's nerves are damaged either during pregnancy (spina bifida) or after birth (by an accident), then his or her bladder can become neurogenic.

Who gets a neurogenic bladder?

Children with spinal cord injuries or spinal cord abnormalities, such as spina bifida, are at risk for neurogenic bladders. Therefore, it is very important for mothers to take folic acid during pregnancy to reduce the risk of their child being born with spina bifida.

What are the signs and symptoms of a neurogenic bladder?

The most common symptoms of neurogenic bladder are:

  • Urinary accidents and being wet during the day and night without control
  • Recurrent urinary tract infections
  • Kidney damage due to the high pressure in the bladder
  • Kidney stones, which can cause pain and urinary tract infections

How do doctors at Children's Hospital Colorado make a diagnosis?

The diagnosis is made by a pediatric urologist who completes medical history, exam and urodynamics testing. A kidney ultrasound is performed routinely to examine the kidneys and bladder. A urodynamics test may also be performed to evaluate the function of the bladder. This is an invasive test in which catheters are placed in the bladder and the pressure within the bladder measured.

How is a neurogenic bladder treated?

Once the child is born, some of the effects of the disease can be prevented or reduced with aggressive management and, if appropriate, surgical reconstruction. Treatment may include:

  • Passing a catheter into the bladder every 3 to 4 hours to drain urine out of the bladder (CIC - Clean Intermittent Catheterization)
  • A prophylactic antibiotic (low dose) to prevent infections
  • Medications (oxybutynin) that can help control the activity of the bladder
  • Surgery, which is aimed to make the bladder big enough to hold urine for 3 to 4 hours without leaking

Why choose Children's Colorado for your child's neurogenic bladder?

At Children's Colorado, our urology specialists participate in a multidisciplinary clinic. This clinic sees patients with spinal cord anomalies and injury to manage the neurogenic bladder, monitor the kidneys and coordinate care with a number of other specialty practices, including orthopedics, rehabilitation, neurosurgery and social work.

With this coordination of services, we are able to provide the best care to your child and help them maintain health and independence.

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