Neurourology

Your brain, spinal cord and nerves play a vital role in the health of your urinary system. But nerve damage or neurological diseases can affect bladder control. If you’re trying to manage nerve-related urinary problems, we can help. 

UMass Memorial Medical Center in Worcester is home to a urologist with specialized training in neurourology. We are the only program in the region with this expertise. Our specialist has extensive experience diagnosing and treating urinary issues related to neurological diseases. You have access to a range of nonsurgical and surgical treatments that ease symptoms and improve your quality of life. 

What Is Neurogenic Bladder? 

Nerves control the muscles that tighten and relax to hold and release urine. When these nerves don’t work properly, it’s hard to maintain bladder control. Neurogenic bladder, or neurogenic lower urinary tract dysfunction, is a term that describes urinary symptoms that can develop from neurological disorders. 

Neurogenic bladder takes several forms: 

• Urinary incontinence (involuntary urine leakage)
• Overactive bladder (sudden and frequent urge to urinate)
• Underactive bladder (difficulty emptying your bladder or a weak urine stream)
   

What Causes Nerve-Related Bladder Problems? 

A range of neurological disorders can affect the urinary system and bladder function. Some conditions develop over time, while others are present from birth or result from injury, surgery or other health problems.

• Cerebral palsy
• Hydrocephalus
• Multiple sclerosis (MS)
• Parkinson’s disease
• Spina bifida
• Spinal cord injury
• Stroke
   

Our Treatments for Incontinence, Overactive Bladder and Underactive Bladder 

We help men and women find relief from nerve-related bladder problems with a range of evidence-based therapies. Our neurourology specialist selects the best treatments for your needs based on an individualized assessment and advanced diagnostic testing. 

Your treatment plan for urinary dysfunction may include: 

• Lifestyle changes: Changing your diet, such as limiting foods and drinks that irritate your bladder, may provide some relief. You can also practice holding your urine and emptying your bladder at set times, called scheduled voiding.
• Pelvic floor physical therapy: Pelvic floor exercises strengthen muscles that support your bladder. You regain the ability to tighten and relax the muscles, giving you better control over urination.
• Medication: If you have an overactive bladder, medication can relax your bladder muscles and ease symptoms of urinary urgency or frequent urination. You may take the medication as a pill or apply a gel or patch to your skin.
• Catheterization: A catheter (thin, flexible tube) in your urethra can help empty urine from an underactive bladder. We may recommend an intermittent catheter that you use only when urinating or a continuous catheter that stays in place.  
• Botulinum toxin injections: Botox injections in your bladder relax muscles and reduce symptoms of urgency incontinence and overactive bladder. Botox results are temporary.
• Sacral nerve stimulation: InterStim Therapy works like a pacemaker for your bladder. We implant a device under your skin in your hip or buttocks. It delivers mild electrical stimulation to your sacral nerves to regulate bladder function.
• Surgery: We may recommend augmentation cystoplasty to enlarge your bladder so it can hold more urine. Other procedures address your urethral sphincter, the muscle that opens and shuts your urethra.