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Neurogenic Bladder after Childhood Cancer Treatment

What is neurogenic bladder?

Most survivors of childhood cancer do not have problems with their urinary bladder as a result of their treatment. But certain types of cancer and cancer treatments can damage the bladder.

One such condition is neurogenic bladder. A neurogenic bladder is loss of bladder control due to a brain, spinal cord, or nerve problem. 

A neurogenic bladder may not empty completely (underactive) or empty too often (overactive). 

People with neurogenic bladders also have an increased risk of urinary tract infection (UTI) and kidney damage. 

Risk factors for neurogenic bladder

Risk factors for neurogenic bladder include:

  • Tumors involving the bladder, prostate, pelvis, spine, or in nerves or areas of the brain that affect the bladder
  • Surgery or radiation in these areas

Symptoms of neurogenic bladder

Signs and symptoms of neurogenic bladder include:

  • Sudden urge to urinate
  • Needing to urinate more often than normal
  • Weak stream of urine
  • Having to push hard to urinate
  • Not being able to urinate
  • Pain while urinating
  • Not being able to control your urine
Medical illustration of a voiding cystourethrogram (VCUG). Image of person on left. On the right shows three images of kidneys and bladder. One image is to show that a catheter is placed through the urethra into the bladder. Another image on the right of a contrast liquid that flows into the bladder. Third image on the right is a Voiding Cystourethrogram (VCUG) can show if the urine is flowing in the wrong direction.

A VCUG test can help diagnose neurogenic bladder.

Diagnosis of neurogenic bladder

To diagnose neurogenic bladder, a doctor will order tests to measure how well the bladder can store and empty urine. 

These tests include a voiding cystourethrogram (VCUG) or bladder cystometry. A cystometry is a test that measures the pressure inside the bladder.

Treatment for neurogenic bladder

Treatment depends on the cause of problems. It may include:

  • Medicines to calm overactive bladder
  • Training and counseling to help patients manage bladder problems
  • Surgery to improve bladder control and function
  • A urinary catheter for patients who cannot empty their bladder. A urinary catheter is a narrow tube that goes into the bladder. This can prevent pressure from building up in the bladder. The pressure can interfere with the flow of urine.

Call your health care provider if you:

  • Wake up more than usual during the night to urinate
  • Leak urine 
  • Have fever or pain when you urinate
  • See blood in your urine

Questions to ask your care team about neurogenic bladder

  • What tests and screenings should I have?
  • When should I call the doctor if I have symptoms of a problem?
  • Do I need to follow a special diet?
  • Do I need to make any changes to my school or work?

Key points about neurogenic bladder

  • Neurogenic bladder is loss of bladder control due to a brain, spinal cord, or nerve problem. 
  • This is a rare side effect of radiation and surgery to treat tumors in the pelvic region.
  • Symptoms may include problems with urination. Problems may include needing to urinate more often than usual, not being able to urinate, or pain during urination.
  • Treatment may include surgery, medicines, or a urinary catheter. 

Reviewed: October 2023