Types of neurogenic bladder

Neurogenic-bladder dysfunction is a condition caused by damage to the brain, spinal cord or nerves that control bladder function, resulting in the inability to control your bladder.

Imagine your bladder as a tank of water. With a healthy nervous system, nerves carry messages from the bladder to the brain to let it know when the bladder is full and needs to be emptied. The brain then sends signals back to the bladder to empty the tank. However, in people with neurogenic bladder dysfunction there’s a disruption in this communication process due to damage to the nerves, spinal cord or brain.

When this breakdown in communication happens, you can have one of the two main types of neurogenic bladder, an overactive bladder (spastic or hyperreflexia) or underactive bladder (flaccid or hypotonic). You can also have mixed neurogenic bladder, which happens when you have symptoms of an overactive and underactive bladder.

Have more questions about neurogenic bladder? Learn more in our neurogenic bladder FAQ.

Three types of neurogenic bladder

Each of the types of neurogenic bladder has its own set of causes, symptoms and treatments. Yet, both overactive and underactive neurogenic bladder are caused by a nervous system that doesn’t work well with the muscles that control the bladder.

Overactive bladder

An overactive bladder (spastic neurogenic bladder) is a type of neurogenic bladder that causes you to lose control over your bladder. You may feel the frequent or urgent need to urinate, which can be difficult to control.

An overactive bladder is characterized by uncontrolled bladder contractions due to a breakdown between the signals to and from the brain and bladder, causing it to be overly excited and hyperactive.

The most common cause of overactive neurogenic bladder is damage to the brain or the spinal cord due to conditions such as having a stroke, multiple sclerosis, Parkinson’s disease or Alzheimer’s disease. Spinal cord injury can also lead to an overactive bladder.

Underactive bladder

While an overactive bladder is characterized by hyperstimulation of the nerves and muscles in the bladder, an underactive bladder (flaccid neurogenic bladder) doesn’t contract enough. This leads to urinary retention or the inability to fully empty the bladder.

In this case, the bladder stretches and can hold abnormal amounts of urine. Left untreated, an underactive bladder can cause overflow incontinence where the bladder gets so full that it leaks urine. If you have an underactive bladder, you are at a higher risk of developing a urinary tract infection (UTI).

Damage to the peripheral nerves that control bladder function is the most common cause of underactive bladder.

Other causes of an underactive bladder include:

• Chronic obstruction due to an enlarged prostate
• Scarring of the urethra (which can occur in postmenopausal women)
• Diabetic neuropathy
• Spina bifida
• Pelvic surgery

Mixed neurogenic bladder

In some cases, you may experience a mix of symptoms for overactive bladder and underactive bladder. This type of neurogenic bladder is known as a mixed neurogenic bladder, which can cause you to struggle with urgency, frequency and urine retention. People with multiple sclerosis or severe spinal cord injuries are more likely to have mixed neurogenic bladder.

Understanding the neurogenic bladder classifications can help manage this condition. For more information find an Aurora urologist near you and get answers to frequently asked questions.