Neurogenic Bladder in Children

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A neurogenic bladder may be diagnosed when nerve damage causes the bladder muscles to stop functioning properly. This can result in urine leakage (urinary incontinence) and urine retention, when the bladder cannot fully empty. Urinary tract infections can also occur.

While a neurogenic bladder cannot be cured, Duke pediatric urologists offer the most advanced treatment options. We help your child cope with the condition, manage the symptoms, prevent complications, and live a normal life.

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What Causes Neurogenic Bladder

In a properly functioning nervous system, the brain tells the bladder muscles to hold or release urine. When the muscles and nerves don’t work as they should, there is pressure on and damage to the kidneys. The nerve damage that causes neurogenic bladders is typically due to another condition, such as spina bifida, spinal cord trauma, tumors in the central nervous system, or birth defects that impact the anus.

Our Locations

Duke Health treats children with neurogenic bladder at locations in Durham and Raleigh. Find one near you.

Testing for a Neurogenic Bladder

Our providers will compile your child’s medical history and complete a physical exam to identify the underlying cause of their neurogenic bladder. Testing is performed to assess your child’s bladder control and design the best treatment options.

Ultrasound

Sound waves create detailed images of the bladder and kidneys. 

Urodynamic Imaging

A catheter is used to fill your child’s bladder with a salt water solution. Pressure measurements are taken as the bladder fills and empties during urination. This involves placing one catheter through your child’s urethra and another into the anus. If needed, this can be done under sedation.

Video Urodynamics

This test combines urodynamic imaging and specialized X-rays. The bladder is filled with a safe, radiographic dye, which allows X-rays to be taken while the bladder fills and empties. The video helps your doctor locate vesicoureteral reflux or defects of the bladder’s muscle.

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Nonsurgical Treatments for Neurogenic Bladder

Your pediatric urology team will consider your child’s age, health, and medical history when making treatment recommendations. Treatments can’t cure neurogenic bladder, but they can help minimize symptoms and prevent complications.

Self-Catheterization

Also known as intermittent catheterization, this treatment offers a solution for challenges with urination. A pediatric urologist will teach you and your child to insert a thin, plastic tube called a catheter through the urethra and into the bladder. The catheter allows them to empty their bladder in regular intervals. For some children, a permanent catheter may be needed as a long-term solution.

Medication

Medications that can safely reduce muscle overactivity of the bladder may be prescribed.

Botox

Injections into the bladder improve bladder function by decreasing muscular contractions that can cause incontinence. This is not a permanent solution. It can offer relief for up to eight months.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Surgical Treatments for Neurogenic Bladder

In rare cases, your child may need surgery to manage their neurogenic bladder. Every procedure is performed by a fellowship-trained, pediatric urologist with expertise in treating neurogenic bladder.

Cystoplasty

Also known as bladder augmentation, this procedure makes the bladder larger so it can hold larger amounts urine and reduce uncomfortable pressure from storing urine. 

Mitrofanoff Procedure

A one-way channel is created that connects the bladder to the surface of the abdomen. Your child will use a catheter to expel urine through this new channel.

Bladder Outlet Procedures

Parts of the bladder and urethra are reconstructed to improve the bladder’s ability to hold urine. This improves urinary incontinence and minimizes leakage.

Why Choose Duke

Researching New Kinds of Care
Our pediatric urologists are part of ongoing research programs supported by the Centers for Disease Control to better understand and treat neurogenic bladder and the health issues that cause it, like spina bifida. This research helps our team put new findings into practice. 
 
Nationally Recognized Surgical Care
If your child requires surgery to treat neurogenic bladder, Duke is one of just two hospitals in the U.S. verified as a Level I children’s surgery center by the American College of Surgeons. This designation recognizes our commitment to providing the highest-quality surgical care to young patients. 

Experts in Treating Conditions Related to Neurogenic Bladder
Duke Health is a designated clinical care partner of the Spina Bifida Association, which recognizes hospitals and clinics that use best practices to care for people with spina bifida and associated diseases.

This page was medically reviewed on 03/16/2022 by