You are here:

Urology/Neurogenic bladder


I have written to you many times before after having the TURP asking why my bladder was still retaining 20 oz of urine. If you remember it had stored 2 liters when the urologist drained it. Today 11/13/13 I got a second opinion. This urologist says I have a neurogenic bladder. I have looked up the causes which are below:

What causes neurogenic bladder?
Several disorders can cause neurogenic bladder, including the following:

Parkinsonís disease
multiple sclerosis
spinal cord injuries
spinal surgeries
erectile dysfunction
diseases that affect the nervous system
central nervous system tumors
spinal congenital (present at birth) abnormalities
heavy metal poisoning

I have had none of these causes. I have had to my knowledge no nerve damage. This urologist says I have scar tissue AKA bladder wall thickening and the muscle is just to weak to push out all the urine.

So once again I do not understand. Neurogenic bladder is about nerves.  How can I have that when I have not had any cause of nerve damage?  This urologist also says the muscle is too weak.

Can you reconcile neurogenic bladder and muscle weakness? could it be the trauma from the urine retention of 2 liters?

If you can remember you told me there may be additional obstructive tissue after the TURP that was causing the urine retention. This urologist says that does not appear to be the case. No more TUR of TURP are going to help a weakened scar tissue bladder.  

Please try to explain this. Thanks

Right now I can urinate but only after my bladder holds 20 ounces.I can put out 30 or more ounces daily.  IT does no good to delay to catheter because the 20 ounces retained are a breeding ground for infection which I currently have.

Please let me know what I am to expect over the next 6 months. I have to now catheter more frequently and will no know what my bladder is capable of doing.  I am so frustrated.


You need to ask the physician who diagnosed you with neurogenic bladder to account for his diagnosis.  Without some clear underlying neurological problem, the only way to correctly diagnose a neurogenic bladder is by special testing of the bladder muscle looking for denervation sensitivity.  A nerve supply depleted bladder muscle reponds disproportionately strongly when given a drug that mimics the usual nerve signal.  This response can then be measured and used to help diagnose nerve impairment.  Bladder muscle weakness can be due to neurogenic causes or bladder damage from other causes such as diabetes, overstretching and outlet obstruction among others.

Urinary retention of 2 liters can damage the bladder muscle.  It depends how long this lasted and what caused it.  If chronic, there could be permanent bladder muscle damage.

It sounds like they have checked and determined that there is no significant obstruction remaining.  In these cases, intermittent self catheterization or permanent catheters are needed.

I cannot determine what you can expect over the next 6 months as I do not have sufficient information about your case, but your local physicians should be able to answer this for you.


All Answers

Answers by Expert:

Ask Experts


Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

©2016 All rights reserved.