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Neuro-Urology and Urodynamics Centre

Treatments & Procedures

To diagnose a neurogenic bladder, the doctor will take your medical history and perform a physical exam. He will need to determine the type and severity of the disorder. Depending on the information gained the urologist may prescribe one or more diagnostic procedures to develop an effective treatment plan.

A urine flow test or pressure flow cystometry may be used. Another test records fluid intake and urinary output, sometimes using a catheter to empty the bladder, and a cystoscope can be used to assess the anatomy inside the bladder.

Treatment for neurogenic bladder depends greatly on the diagnosis and severity of the problem. Your doctor may use catheterizations, medications, control of fluids, even exercise. An anticholinergic medication may be used to treat incontinence associated with a nervous system disorder (e.g., Parkinson's disease, multiple sclerosis, cerebral palsy). These medications relax bladder smooth muscle. In extreme cases, a urinary diversion is necessary, which involves re-routing of the urinary stream.

Intermittent self-catheterization is a safe and effective method of com1pletely emptying the bladder every 3 to 8 hours, or as recommended by your doctor. Your fluid intake is directly related to urine output and the frequency of catheterization. If catheterization is being used, one should never skip it. It is crucial to empty the bladder on a schedule. The risk for infection is greater from a full bladder than from an unwashed catheter so even if it is accidently dropped, it should be washed and used on time and not delay the catheterization more than an hour or two. If you get any of the following symptoms, it most likely means your bladder needs to be emptied; chills, distended bladder, feeling of fullness, headache, perspiration, or restlessness.

We offer treatment for: Benign prostate hyperplasia (BPH) treatment, Circumcisions, Cystoscopy, Genitourinary cancer treatment, Male infertility, Pelvic organ prolapsed, Reconstructive urology, Stone disease care (kidney, ureteral, bladder), Urodynamics, Urogynecology, Urologic oncology care, including state-of-the-art care of bladder, prostate, kidney, renal, testicular and penile cancer, Vasectomy and Vasectomy reversals.

Our Neurourology team follows a large group of patients who have spinal cord injury, multiple sclerosis, diabetes mellitus, cerebrovascular disorders and other neurologic conditions. Our objective is to prevent all urologic complications associated with a neurogenic bladder.

Our urology department physicians have extensive experience in reconstructive urologic surgery. This includes bladder enlargement or replacement procedures, and urethral repair and reconstruction. Lower urinary tract reconstruction can be very complicated and multistaged (completed in several stages). We can rebuild bladders and strengthen or replace urethra continence with a neourethra. This requires precise diagnosis and careful planning of the staged reconstructive procedure(s). Our urology clinic has the right equipment and personnel to do this surgery, and to carry out a comprehensive treatment plan.

We often deal with pelvic organ and vaginal prolapse conditions often associated with stress incontinence symptoms. These conditions may require gynecologic assistance that is readily available in our multidisciplinary clinic setting and our operating room. Our treatment for complicated incontinence starts with a thorough fluorodynamic evaluation and may include medical therapy or various surgical procedures, from outpatient collagen injection to sophisticated reconstructive operations. Occasionally, urinary leakage is the result of an abnormal connection or fistula, but our physicians have extensive knowledge and experience in diagnosing and treating this somewhat rare condition.

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