Treatments for Neurogenic Bladder in Children

It's entirely natural that you might be concerned, right now, about your child's health; a diagnosis of neurogenic bladder can be frightening. But you can rest assured that at Boston Children's Hospital, your child is in good hands.

While neurogenic bladder can't be cured, necessarily, it can most definitely be managed. Most children will receive medication and intermittent catheterization. Few of them need major reconstructive surgery.

Many parents worry that frequent catheterization can lead to constant infection (and that their child will always have a urinary tract infection). However, while intermittent catheterization is associated with a higher risk of infection, these risks can be regulated with medication and/ or prevented with antibiotics.

Generally speaking, changes can occur over the lifetime of your child, and that's why we're committed to following him throughout his childhood, adolescence and young adulthood. We will monitor your child closely: Sometimes things change for the better and sometimes for the worse. Unfortunately, we don't have a good way of predicting when that's going to happen. What we do know is that in the past, spina bifida almost always led to a life of incontinence; this is no longer the case.

How exactly is neurogenic bladder treated?

Your child's treatment for neurogenic bladder may include: 

  • insertion of a very small catheter, or hollow tube, to empty the bladder at regular intervals 
  • antibiotics to prevent urinary tract infection 
  • medication to help relax the bladder 
  • surgery to enlarge the bladder if it is very small and not responsive to medication
  • surgery to insert an artificial sphincter or a bladder neck sling, both of which can be used to prevent urinary incontinence

In caring for patients affected by neurogenic bladder, what sets Children's apart are 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 in both Boston and Waltham 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.