Bladder Disorders

The purpose of the bladder is to store urine and control its flow. Normally, this process works efficiently. However, there are times when certain disorders affect how the bladder functions.

Two of the most common bladder disorders are an overactive bladder and what’s referred to as a neurogenic bladder.

Having an overactive bladder typically means experiencing a frequent urge to urinate. A bladder that’s overactive may also contribute to an inability to fight the urge to urinate, urine leakage, or getting up at night to urinate. Overactive bladder is caused by involuntary contractions of bladder muscles that trigger the urge to urinate when the volume of urine in the bladder is low.

In some instances, overactive bladder symptoms may develop as a result of stroke, multiple sclerosis (MS), and other neurological disorders. Bladder muscles might also be affected by:

• The natural physical aging process
• Severe or recurring urinary tract infections
• Bladder abnormalities
• Age-related cognitive decline
• Medications that may affect urine production

A neurogenic bladder is a bladder affected by nerve-related damage. It’s often associated with urge incontinence (UI) and may result in increased urination frequency, overflow, and urine retention. The nerve damage may be related to an assortment of underlying conditions, including Parkinson’s disease, diabetes, and spinal cord or brain injuries. It’s also possible for nerves to be damaged during pelvic surgery for another condition.

Unless symptoms are severe, overactive bladder is usually initially treated with non-surgical methods. Some patients respond well to bladder training techniques, a set toilet schedule, urge incontinence medications, biofeedback, or the use of a device inserted into the vagina called a pessary. Urination urgency might also be controlled with nerve stimulation or bladder injections of Botox. If surgery is necessary for overactive bladder, options include:

• Bladder removal and the creation of an artificial bladder (neobladder)
• Replacement of part of the bladder with a portion of the bowel
• Implanting a sling or mini-sling with surgical mesh to support the urethra and bladder

Neurological bladder injuries or conditions may be treated with anti-cholinergics or Botox to relax bladder muscles. A surgical treatment option for neurological bladder is the insertion of a wire device called a sacral nerve stimulator. The device can be used on a trial basis to determine if it’s effective before the implantation of a battery under the skin. If other treatment efforts are ineffective, surgery may be performed to expand the bladder’s capacity.

You may be able to reduce your risk of developing a serious bladder disorder by opting for a generally healthy lifestyle. In order to achieve this goal, a urologist may recommend maintaining a healthy weight, being careful with caffeine and alcohol consumption, quitting smoking, and doing exercises that strengthen bladder-supporting pelvic floor muscles. Managing chronic conditions like diabetes may also help keep your bladder functioning properly.