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.
How the bladder functions
How the bladder functions:
The urinary bladder stores urine (pee).
The kidneys filter the blood and make urine.
Urine enters the bladder through 2 tubes called ureters.
The urine leaves the bladder through the urethra.
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
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.
Most survivors of childhood cancer do not experience problems with their urinary bladder because of their cancer treatment. But certain therapies can affect how the bladder functions.
A VCUG can show if a childhood cancer patient has a condition called vesicoureteral (VU) reflux. This condition causes urine to flow in the wrong direction, from the bladder back up to the kidneys.