Neurogenic Bladder and reflex incontinence

Reflex incontinence or neurogenic bladder is the collective term for incontinence caused by neurological conditions. A variety of neurological disorders and diseases, including multiple sclerosis (MS), a paraplegia and spina bifida, can cause problems with bladder control.

What is neurogenic bladder?

Reflex incontinence or neurogenic bladder is leakage due to abnormal or damaged nerve signals to the bladder. People with reflex incontinence may experience loss of bladder control or even feel no urge to urinate. Because the involuntary urination often occurs without warning, this form of continence is also called neurogenic incontinence. The degree of loss of urine varies from person to person, but often the entire bladder volume is involved. Depending on the cause of the incontinence, different management and treatment options exist.

Causes of reflex incontinence

The nerves and the spinal cord play an important role in neurogenic bladder. The spinal cord is linked to various parts of the body, including the bladder, via the nerves. Nerves carry messages between the bladder, the spinal cord and the brain, telling the bladder muscles when to contract or relax. In neurogenic bladder or reflex incontinence, this process does not work the way it should.

Reflex incontinence is caused by abnormalities in the nervous system that lead to disturbed reflexes in the brain.

Common causes include: diabetes, paraplegia, spina bifida, tumors, multiple sclerosis (MS), Parkinson's disease, cerebral infarction or cerebral hemorrhage, and damaged nerves as a result of surgery, accidents or infections.

Treatment of reflex incontinence

Reflex incontinence can be difficult to treat because it is caused by underlying health problems. While the treatment should always be individualized and dependent on the cause of the incontinence, it is generally centered on reducing uncomfortable symptoms and on preventing permanent kidney damage.

The first step should always include consulting with a doctor or health care professional to determine the type and cause of incontinence. They can often diagnose reflex or neurogenic incontinence on the basis of someone's medical records, although sometimes other tests may be needed, such as x-rays, ultrasounds or blood tests.

In addition, a doctor may request a keeping a urination journal.

Tips for reflex incontinence:

  1. Healthy eating and staying hydrated helps improve the symptoms of incontinence.  In addition, it is important to avoid alcohol, caffeine-containing beverages and spicy food as much as possible.
  2. Absorbent incontinence products can make life with reflex incontinence more comfortable, as it protects against leaks, prevents unpleasant odors and reduces the risk of incontinence associated skin problems (IAD).
  3. People who cannot empty their bladder independently have a higher risk of urinary tract infections and kidney problems. Regular catheterization is sometimes necessary to flush the residual urine from the bladder
  4. In some cases, surgery can resolve neurogenic incontinence or the underlying nervous system problems. Because of the risk of complications, however, this is rarely the best option.

Incontinence products and reflex incontinence

There is no special incontinence product for neurogenic incontinence. The best choice of incontinence product  is determined based on the severity of urine loss, product size and patient mobility.  A nurse, pharmacy assistant or home care staff can help you make a choice. In addition, it is also possible to consult the ABENA incontinence nurses for advice.

Read more about choosing the right incontinence product

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