Neurogenic Bladder after Childhood Cancer Treatment

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 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 be underactive (not emptying completely) or overactive (emptying too frequently or quickly). People with neurogenic bladders also have an increased risk of urinary tract infections (UTIs) and kidney damage.

How the bladder functions

The urinary bladder stores urine. The kidneys filter the blood and make urine. It enters the bladder through 2 tubes called ureters. The urine leaves the bladder through the urethra.

Risk factors for neurogenic bladder

• Tumors involving the bladder, prostate, pelvis, or spine
• Surgery or radiation in these areas

Signs and symptoms of neurogenic bladder

• Sudden urge to urinate
• Need to urinate frequently
• Dribbling during urination
• Straining to urinate
• Inability to urinate

Diagnosis of neurogenic bladder

If a neurogenic bladder is suspected, survivors should have an evaluation by a urologist.

The urologist will order tests to determine 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 to see how well the bladder is working.

Treatment for neurogenic bladder

Treatment depends on the person’s medical needs.

• Medications may be useful for an overactive bladder or for a bladder that does not store urine properly.
• Surgery to enlarge the size of the bladder may be necessary if medications do not work.
• A catheter might be necessary if the patient can’t completely empty the bladder. A catheter is a small, clean tube. It is inserted into the urethra to remove urine several times of day. This procedure can prevent pressure from building up in the bladder. This pressure can interfere with the flow of urine from the ureters and kidneys.

Call your health care provider if:

• Awakened more than usual during the night to urinate
• Leakage of urine occurs
• Fever or pain is present
• Blood is present in urine