How is nonneurogenic neurogenic bladder treated?

Updated: Dec 27, 2018
  • Author: Frances M Dyro, MD; Chief Editor: Robert A Egan, MD  more...
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Answer

Answer

Occasionally, children exhibit what appears to be a neurogenic bladder without any other evidence of neurologic dysfunction. This “nonneurogenic” neurogenic (ie, Hinman) bladder is an acquired dysfunction that is seen most frequently in young girls but may also be seen in women after painful pelvic surgery.

Early toilet training proceeds normally, but at some point, usually at about the time they enter school, these children develop a pattern of holding back and suppressing bladder contractions. This may be from fear of using a toilet away from home or of being bullied at school. Eventually, the bladder becomes distended and insensitive. The sphincters intermittently relax, with resultant leakage. With attempts to void, the stream is slow, and the child cuts it off before emptying completely.

This condition also may affect bowel function and, in extreme cases, may resemble Hirschsprung disorder. Frequent urinary tract infections are the rule in these patients. Urethral dilatations may help transiently. This disorder requires psychological intervention as well as timed voiding, keeping a voiding diary, and often intermittent catheterization until bladder elasticity returns. This is not a neurologic disorder.


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