Diagnosis of Neurogenic Bladder

Q 1. How to diagnose Neurogenic Bladder?

A. Early diagnosis and treatment are essential in neuro-urological disorders. Early intervention can prevent irreversible changes of the lower and upper urinary tract.

When diagnosing neuro-urological symptoms, your doctor may:

• Take a thorough medical history
• Ask you to keep a bladder diary
• Ask you to complete a quality-of-life questionnaire
• Do a physical examination
• Test how your bladder fills and empties with pressure measurements (urodynamics)
• Check your kidney function

Medical history: Medical history is the cornerstone of evaluation. The answers will help determine diagnosis and treatment options.

• Your doctor will ask you about past and present symptoms and illnesses.
• Your doctor also might want to know all medications you are taking regularly.
• The questions may address urinary and bowel symptoms as well as sexual function.
• Patients with neuro-urological symptoms may have related bowel and sexual problems.

Bladder diary: Your doctor may ask you to keep a bladder diary. You will be asked to document the number of times you urinated, the volume of urine passed, pad weight if you are using pads, and incontinence and urgency episodes. This is typically done over 24 hours and for 3 consecutive days to help identify the problem.

Quality-of-life questionnaires: Your doctor may ask you to fill out several questionnaires to assess your present and future quality of life. This aspect is important to monitor the effect of your therapy.

Physical examination: Your doctor may also do a thorough physical examination. The examination tests all sensations and reflexes in the urogenital area as well as the anal sphincter and pelvic floor functions. This information is needed to understand later diagnostic tests.

Your doctor may also decide to analyse your urine and blood chemistry. Ultrasound or other imaging techniques may be recommended to evaluate the urinary tract.

Urodynamics: Urodynamic tests help your doctor to assess the function of your bladder.

Kidney function: In many patients with neuro-urological disorders, kidney function is at risk. Patients with spinal cord injury or birth defects of the spinal cord have an especially high risk of developing kidney failure. Your doctor will watch carefully for any signs or symptoms of possible deterioration of kidney function.