UROLOGY · CONDITIONS
Neurogenic Bladder
Bladder dysfunction caused by neurological disease or injury, requiring systematic evaluation and a structured management plan to protect the upper urinary tracts and restore continence.
ABOUT THIS CONDITION
What is Neurogenic Bladder?
Neurogenic bladder results from disruption of the neural pathways controlling bladder and sphincter function due to spinal cord injury, multiple sclerosis, Parkinson's disease, diabetes, or stroke. It manifests as urinary incontinence, retention, or a combination. The primary goal is protecting the upper urinary tracts from high bladder pressures. Dr. Vipin provides a comprehensive neurogenic bladder service — urodynamic evaluation, clean intermittent catheterisation training, Botox injections, and surgical options including augmentation cystoplasty, Mitrofanoff procedure, and sacral neuromodulation — tailored to each patient's neurological level and functional status.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Spinal cord injury — above or below the sacral segments
- Multiple sclerosis — demyelination of bladder control pathways
- Parkinson's disease — dopaminergic dysfunction
- Diabetic cystopathy — peripheral neuropathy
- Stroke — loss of cortical inhibition of voiding
- Sacral agenesis or spina bifida (congenital)
CLINICAL DETAILS
KeyFacts
Video urodynamics is essential — characterises bladder and sphincter dysfunction precisely before treatment.
Clean intermittent catheterisation is safe, effective, and protects the upper tracts from high-pressure damage.
Intradetrusor botulinum toxin injection reduces overactivity — effective for 6–9 months per injection.
Ileocystoplasty increases bladder capacity and reduces pressure — protecting the kidneys permanently.
Sacral nerve stimulation (InterStim) effective for refractory urgency incontinence and urinary retention.
Catheterisable abdominal channel for patients unable to catheterise urethrally due to physical limitations.
HOW WE TREAT IT
Treatment Approach
Augmentation Cystoplasty (Ileocystoplasty)
A detubularised intestinal segment is incorporated into the bladder to create a large, low-pressure reservoir — protecting the kidneys from high-pressure detrusor contractions and providing long-term continence.
- 1
Urodynamic Assessment
Video urodynamics characterises the type of neurogenic bladder — overactive, underactive, or combined — and assesses bladder capacity and compliance.
- 2
CIC Training
Clean intermittent catheterisation is taught by specialist nurses — the most important and effective initial management for most neurogenic bladder types.
- 3
Botox Injections
Intradetrusor Botox injected cystoscopically reduces detrusor overactivity and urgency incontinence — repeated every 6–9 months as needed.
- 4
Surgical Options
Augmentation cystoplasty, Mitrofanoff procedure, sacral neuromodulation, or ileal conduit planned for patients who fail conservative management.
AVAILABLE TREATMENTS
Treatment Options
Augmentation Cystoplasty (Ileocystoplasty)
Intestinal segment incorporated into the bladder — creates a large, low-pressure reservoir protecting kidneys from high detrusor pressures.
Mitrofanoff Procedure (Appendicovesicostomy)
Continent catheterisable channel (appendix or ileum) to the umbilicus — allows CIC without urethral access for patients with physical limitations.
Ileal Conduit / Urinary Diversion
Incontinent ileal diversion for severe neurogenic bladder where conservative management has failed and high-pressure damage threatens the upper tracts.
Sacral Neuromodulation (InterStim implant)
Implanted device delivering electrical stimulation to S3 sacral nerve — modulates bladder and sphincter function for refractory urgency incontinence and retention.
Bladder Neck Procedure / Sling
Bladder neck sling to increase urethral resistance in neurogenic sphincter deficiency — improves continence between catheterisations.
COMMON QUESTIONS
Frequently Asked
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