Neurourology-Neurogenic Bladder Dysfunction

Various neurological diseases and conditions can adversely affect lower urinary tract (bladder and urinary sphincters) function leading to inability to urinate, urinary incontinence, recurrent urinary tract infections, urinary stones, and even kidney failure. This is referred to as neurogenic bladder dysfunction. Conditions that cause neurogenic bladder include but are not limited to multiple sclerosis, spinal cord injury, spina bifida, strokes, brain or spinal cord tumors, and herniated discs. Managing the urinary bladder aggressively and correctly is of utmost importance when these conditions exist since mismanagement can lead to the serious complications.

Urodynamic studies, which are the measurement of pressure within the bladder and the urinary sphincters combined with simultaneous x-ray imaging, are used to assess the type and severity of bladder dysfunction caused by the neurologic disease. Harper Hospital has a state of the art urodynamics laboratory where patients with all types of lower urinary tract problems are evaluated. The Department of Urology works closely with the Department of Neurology as well as with the Department of Physical Medicine and Rehabilitation in the treatment of patients with neurologic disease and neurogenic bladder.

The Neurology Department at Wayne State University is well known for its expertise in multiple sclerosis. A wealth of urologic experience in evaluating these patients for their voiding problems has been gained by the Urodynamics Laboratory and the Urology Department at Wayne State University.

The management of neurogenic bladder is "pressure based" and dependent on urodynamic evaluation. Most patients can be managed with oral medications alone or in combination with clean intermittent self catheterization (CISC). Some patients, however, require surgical bladder augmentation or urinary diversion.