Neurologic conditions such as multiple sclerosis (MS), spinal cord injury, Parkinson’s and stroke can affect the bladder. It is important that women receive contemporary bladder care as patients with neurologic problems are living longer thanks to improvements in medicine.
Conservative treatment options are equally important in this group of women and may not have been offered previously. Sexual and bowel function are also considered in the contemporary treatment plans. Other common conditions that affect women in general, such as pelvic floor dysfunction, prolapse, and stress incontinence will be addressed. We have the ability to treat urogynecologic (female problems) non-neurologic and neurologic.
In addition to a thorough history and physical exam, a neurogenic bladder requires some further consideration. Due to the complexity of these conditions, no two bladder treatment plans are alike. Renal ultrasound and urine cultures are routinely obtained. Urodynamics (a test that helps demonstrate how the bladder is functioning) and cystoscopy (a test to look at the physical appearance of the bladder) are important adjuncts in developing a customized treatment plan. The FDA approved the use of Botox in the bladder in 2008. Botox has made a dramatic impact in bladder symptoms for these patients.
It is important that our patients are actively involved in creating a plan that fits her bladder needs and addresses her symptoms. Many neurologic conditions change with time, so it is important to have yearly follow-up and monitoring of the bladder and kidneys. This should be done even if treatment plans are not started.