Urology Awareness Month: recognising the causes and symptoms of neurogenic bladder

Posted: 27/09/2018

September is Urology Awareness Month and the purpose of this campaign is to increase public awareness of the various urological diseases that affect individuals, as well as the significant impact these conditions can have on their lives.

The Urology Foundation, the charity that promotes this important campaign, estimates that half of us will be affected by a urology condition in our lifetime and despite the advances in medicine, urology based diseases and conditions are becoming more prevalent.

This article aims to highlight a condition called ‘neurogenic bladder’, which can be caused by a rare condition called Cauda Equina Syndrome (CES).

Neurogenic bladder is the name given to a number of urinary conditions in people who lack bladder control due to a brain, spinal cord or nerve problem. Symptoms can include urinary incontinence, an overactive bladder, and / or urinary retention, which can all have a significant impact on quality of life. Early and proper management is therefore important to promote continence and preserve renal function.

Whilst nerve damage that causes a neurogenic bladder can arise out of diseases such as multiple sclerosis, Parkinson's disease or diabetes, or due to infection or spinal cord injury, it is also a known consequence of CES. In the UK alone, it is estimated that CES will arise in between 1 and 3 people per 100,000. Statistics show that the condition primarily affects adults, although it can arise in people of any age if caused by trauma / spinal injury. It has also been known to affect people who have undergone surgery for lumbar herniated disc problems.

CES occurs when the nerve roots located at the bottom of the spine, known as the Cauda Equina, compress and disrupt motor and sensory function to the lower extremities and bladder. It can cause one or more of the following:

• severe lower back pain;
• bladder and / or bowel dysfunction;
• reduced sensation in the saddle (perineal) area, and sexual dysfunction; and
• neurological deficit in the lower limbs (motor / sensory loss, reflex change).

Any of the above symptoms should reasonably give rise to a suspicion of CES and therefore prompt urgent investigation and treatment. The condition is considered a surgical emergency, as delayed treatment can lead to permanent incontinence and even permanent paralysis. For more information on the diagnosis and treatment of CES, visit our webpage.  

Naomi Holland, an associate in the clinical negligence team at Penningtons Manches, comments: “Raising awareness of various urology conditions and diseases, as well as the potential causes, is very important in order to empower individuals with the knowledge to take more control of their health. As CES is a relatively rare condition, healthcare professionals are often unaware of it and as a consequence, it can be misdiagnosed as simple back pain or sciatica which can result in delays in diagnosis and treatment.

“Sadly, we have experience in dealing with many cases involving delayed diagnosis of CES, and in some of these, clients have been left with permanent and significant bladder problems as well as other debilitating symptoms. By raising awareness through campaigns such as this, we hope that individuals affected by these conditions are given the confidence to seek help and get the treatment they need.

“If you or a family member have been affected by CES, or have concerns relating to the management of a urology condition, please contact our specialist team on 0800 328 9545 for advice.”

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