Treatment of Neurogenic Bladder
Our goals of therapy at Mount Sinai for patients with neurogenic bladder are twofold. The first is to protect the kidneys from harm and preserve kidney function. The second is to improve the quality of life for the patient by minimizing bothersome symptoms.
Oftentimes, simple methods can improve the ability to retain and empty urine, such as:
- Timed voiding, in which patients void according to the clock rather than waiting for the urge to urinate, is often helpful for patients with sensation problems.
- Crede (manual) voiding, where one presses on the lower abdomen to empty the bladder is sometimes useful, but it works better for women than men.
- Clean, intermittent catheterization (CIC) for patients who cannot effectively empty their bladders is a process where patients void through a small tube (catheter) four to six times per day. Ongoing indwelling catheters (catheters allowed to remain in the bladder) are generally not recommended for chronic retention, but may be used as a last resort for select patients
- Medications, such as anticholinergics [Oxybutyin (Ditropan XL®), Tolterodine tartrate (Detrol LA®), and Oxybutynin (Oxtrol®)], are sometimes used in conjunction with CIC programs to relax the bladder and decrease episodes of incontinence.
The Mount Sinai Continence Center team offers numerous surgical techniques, including minimally invasive options which are highly effective and allow for quicker recovery.
- Botulinum toxin-A (Botox®) injection is effective for many patients with incontinence and urinary frequency. This procedure can be done on an ambulatory basis.
- Neuromodulation (InterStim®) involves the implantation of a pacemaker-like device to reduce frequency and incontinent episodes.
- Augumentation cystoplasty (AC) is a surgical procedure to enlarge the bladder using a segment of the patient’s own intestine.
- Complete urinary diversion creates a new bladder with a segment of the patient’s own intestine. Patients may be able to void on their own or catheterize themselves (insert a thin tube called a catheter) through an inconspicuous stoma (opening) on the abdominal wall to empty their bladder.
We can help
If you are experiencing symptoms of neurogenic bladder or have been recently diagnosed, our physicians will provide an in-depth evaluation to ensure optimal treatment based upon your medical profile and needs. Mount Sinai’s Department of Urology is ranked among the nation’s best in the region in the 2013-2014 "Best Hospitals" issue of U.S. News & World Report. Please call us at 212-241-4812 to learn how Dr. Grafstein and his team can help you or a loved one.
Tel: 800-MD-Sinai (800-637-4624)
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