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Neurogenic Bladder in Children

  • A common concern of parents whose children have been diagnosed with neurogenic bladder dysfunction is the question: “Will my child still be in diapers when he’s school age?”

    The short answer is: most likely, no. While it’s impossible to say that your child will never have an accident, a neurogenic bladder can be managed with medication, catheterization and/or routine examinations by his doctors, ensuring that your child will live as normal a life as possible. 

    Here’s what you need to know about neurogenic bladder:

    • Neurogenic bladder is a urinary tract dysfunction in which the bladder doesn’t empty, properly due to a neurological condition or spinal cord injury.

    • The condition may be caused by a birth defect, usually one involving the spinal cord, or it may be acquired as the result of a different problem.

    • While neurogenic bladder can’t be cured, necessarily, it can most definitely be managed.

    • Most cases of neurogenic bladder can be managed with medication and intermittent catheterization.

    • The minority of children with the condition need major reconstructive surgery.

    How Boston Children's Hospital approaches neurogenic bladder

    As the largest pediatric urology service in the world, Children’s Department of Urology performs more than 3,000 surgical procedures each year and cares for almost 18,000 children. Our team of pediatric urologists have extensive experience treating children with neurogenic bladder dysfunction.

    The reality is that neurogenic bladder dysfunction is almost always part of a larger problem; it rarely, if ever, occurs on its own. It’s a common complication of spina bifida (myelodysplasia), a condition in which there’s abnormal development of the spinal cord, and can also be a complication of spinal cord trauma, tumors in the central nervous system and pelvic tumors. Children's has one of the country’s oldest and largest comprehensive interdisciplinary centers for the care of children with spina bifida.

    Our doctors take a multidisciplinary approach to diagnosing and treating your child’s neurogenic bladder, enlisting care from doctors and nurses from Children's Departments of Neurology, Urology, Complex Care Pediatrics, Neurosurgery, Nephrology, Gastroenterology and Pediatric Surgery.

    In caring for patients affected by neurogenic bladder, what sets Children’s apart are our innovations in two key areas:

    • Tissue engineering: Typically, surgeons use a patient’s intestinal tissue to enlarge the bladder. However, the incompatibility of intestinal tissue and bladder tissue can lead to complications. At Children’s, we’ve pioneered innovations in engineering tissue (growing tissue in the laboratory using the patients’ own cells).
      • Using special techniques, our doctors can grow enough of the patient’s own bladder tissue to enlarge or replace the bladder. 

      • The world’s first recipients of tissue augments to enlarge the bladder were at Children’s. 

      • In conjunction with the Harvard Stem Cell Institute, we are testing the use of embryonic stem cells and induced pluripotent stem (iPS) cells to augment bladder tissue, as well as the use of novel materials, like silk.

    • Urodynamics testing: Children's long-standing Neurourology Unit comprehensively evaluates children’s lower urinary tract. We offer urodynamics testing to closely evaluate how the bladder carries out its two main functions: filling and emptying. The results of this testing allows your child's physicians to better diagnose and treat a neurogenic bladder.

    Reviewed by Carlos Estrada, MD
    © Children’s Hospital Boston, 2010

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