• Neurogenic Bladder—Child

    (Bladder, Neurogenic—Child; Neurogenic Incontinence—Child; Incontinence, Neurogenic—Child)

    Definition

    Neurogenic bladder is abnormal bladder function caused by a nerve problem. The bladder may empty too often or at the wrong time. This is called incontinence . In other cases, the bladder may be unable to completely empty the urine. This is called urinary retention. Urine may leak out of the overfilled bladder.
    Bladder With Nerves, Female
    BJ00029 97870 1.jpg
    Copyright © Nucleus Medical Media, Inc.

    Causes

    This condition is caused by problems with the nerves carrying messages between the bladder and the brain. In children, neurogenic bladder may be due to a birth defect that affects the spinal cord, such as spina bifida . It may be caused by:
    • Spinal cord injury
    • Tumors of the brain or spinal cord in the pelvic area
    • Infection of the brain or spinal cord

    Risk Factors

    Risk factors include:
    • Having a birth defect that affects the spinal cord
    • Having certain conditions (eg, injury, tumor, or infection) that affect the spinal cord

    Symptoms

    Symptoms may include:
    • Small amount of urine
    • Frequent urination
    • Dribbling urine
    • Inability to feel that the bladder is full
    • Straining during urination
    • Inability to urinate
    • Overflow of urine from a full bladder
    • Painful urination
    • Urinary tract infection
    • Kidney injury from urine backing up into the bladder
    • Kidney stones
    These symptoms may be caused by other conditions. If your child has any of these symptoms, talk to the doctor.

    Diagnosis

    Your doctor will ask about your child’s symptoms and medical history. A physical exam will also be done. The doctor may ask you to keep a diary of how often your child empties his bladder and other urinary habits. If the doctor thinks that the symptoms may be caused by a nerve problem, your child may need tests, such as:
    • Urinalysis—test of the urine to look for evidence of infection or kidney problems
    • Blood tests—to look for evidence of kidney problems
    • Bladder function tests—to measure how well the muscles of the bladder respond to filling and emptying
    Sometimes imaging tests may also be done, like:
    • X-rays —a test that uses radiation to take a picture of structures inside the body
    • Ultrasound —a test that uses sound waves to examine the kidneys, ureters, and/or bladder
    • Computed tomography (CT) scan —use of x-rays and computers to make detailed images of the kidneys, ureters, and/or bladder
    • Magnetic resonance imaging (MRI) —the use of powerful magnets and radio waves to create images of the brain and/or spinal cord; other imaging tests may be used

    Treatment

    Talk with the doctor about the best treatment plan for your child. Treatment options include the following:

    Medication

    The doctor may recommend that your child take antibiotics to prevent urinary tract infections.

    Catheters

    A thin tube, called a catheter, can be inserted to empty your child’s bladder. You can learn to do this for your child, or a trained healthcare professional may do it.

    Surgery

    If other treatments fail, surgery may be an option. For example, surgery may be needed to enlarge the bladder or to create an artificial sphincter.

    Prevention

    Most cases of neurogenic bladder cannot be prevented. You can help your child avoid spinal cord injuries by taking certain precautions, like wearing a seat belt in the car.

    RESOURCES

    National Association for Continence http://www.nafc.org/

    UrologyHealth.org http://www.urologyhealth.org/

    CANADIAN RESOURCES

    BC Health Guide http://www.bchealthguide.org/

    Canadian/American Spinal Research Organization http://www.csro.com/

    References

    Children’s Hospital Boston. Neurogenic bladder. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1348/mainpageS1348P0.html . Accessed July 12, 2010.

    Children’s Hospital of Wisconsin. Neurogenic bladder. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/22629/router.asp . Accessed July 12, 2010.

    LaRusso L. Neurogenic bladder. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated July 9, 2010. Accessed July 12, 2010.

    Strayer D. Neurogenic bladder. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated November 11, 2008. Accessed July 12, 2010.

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