Neurogenic bladder, a condition that results from nerve damage affecting bladder control, can be challenging to manage. Whether caused by spinal cord injuries, multiple sclerosis (MS), stroke, Parkinson’s disease, or other neurological conditions, it can lead to a variety of urinary symptoms like incontinence, urinary retention, urgency, and frequency. While medical treatments and therapies are essential, daily lifestyle adjustments also play a key role in managing neurogenic bladder effectively.
As a pelvic floor therapist, I often work with patients to develop personalized management strategies. These strategies focus on improving bladder control, preventing complications, and enhancing quality of life. Here are some practical, daily lifestyle tips that can help individuals with neurogenic bladder take control of their symptoms and improve their overall well-being.
- Establish a Regular Voiding Schedule
One of the most effective ways to manage neurogenic bladder is by sticking to a consistent voiding schedule. A timed voiding routine helps prevent bladder overfilling, reduce urgency, and avoid accidents. Rather than waiting for the urge to urinate, patients should aim to use the bathroom at set intervals — for example, every two to three hours during the day.
A voiding schedule is especially helpful for those who may not feel the sensation of bladder fullness due to nerve damage. It trains the bladder to hold urine for a more regular amount of time and prevents overactivity.
- Fluid Management
Balancing fluid intake is critical for bladder health, especially when managing neurogenic bladder. Many people mistakenly believe they should drastically reduce their fluid intake to avoid accidents, but this can lead to other issues like dehydration and concentrated urine, which irritates the bladder and increases urgency.
Instead, patients should aim for steady, consistent fluid intake throughout the day. Drinking smaller amounts frequently is better than consuming large quantities all at once. Here are a few fluid management tips:
- Drink water throughout the day: Water is the best choice, as it keeps the bladder functioning optimally without irritating it.
- Limit fluids close to bedtime: To reduce the need for nighttime trips to the bathroom, taper fluid intake a few hours before going to sleep.
- Avoid or limit bladder irritants: Caffeine, alcohol, carbonated drinks, and acidic juices (like citrus and tomato juice) can irritate the bladder and increase symptoms such as urgency and frequency. Reducing or eliminating these drinks can improve bladder control.
- Follow a Healthy Diet
Diet plays a significant role in managing neurogenic bladder symptoms. Certain foods can act as bladder irritants, worsening symptoms like urgency and incontinence. A bladder-friendly diet focuses on reducing these irritants and supporting digestive health to prevent constipation, which can exacerbate urinary symptoms.
- Avoid bladder irritants: Spicy foods, chocolate, artificial sweeteners, and acidic fruits can worsen bladder sensitivity. It’s helpful to track foods that might trigger bladder issues and reduce them accordingly.
- Incorporate fiber-rich foods: Constipation can place pressure on the bladder and make it harder to control urination. To avoid this, ensure that your diet includes plenty of fiber from whole grains, vegetables, and fruits.
- Stay hydrated with water-rich foods: Fruits and vegetables like cucumbers, watermelon, and celery help with hydration while providing essential nutrients.
- Engage in Pelvic Floor Muscle Training (PFMT)
Pelvic floor muscle exercises, often referred to as Kegels, can be incredibly beneficial for individuals with neurogenic bladder; we strongly recommend learning how to properly kegel as well as how to reverse kegel. Strengthening the pelvic floor muscles provides better support for the bladder, improves sphincter control, and reduces incontinence. In cases of urinary retention, these exercises can help improve muscle coordination for more complete bladder emptying.
To do Kegels, contract your pelvic floor muscles as if you were stopping the flow of urine, hold for a few seconds, and then relax. Repeat these contractions several times a day. Working with a pelvic floor therapist to ensure proper technique and consistency is key, as performing these exercises incorrectly can lead to further issues.
Biofeedback therapy can also assist in this process, as it provides real-time feedback on muscle activation, helping patients refine their technique for better results.
- Monitor for Signs of Urinary Tract Infections (UTIs)
People with neurogenic bladder are at higher risk of developing urinary tract infections (UTIs) due to incomplete bladder emptying or the use of catheters. It’s essential to stay vigilant and recognize early signs of a UTI, such as:
- Cloudy or foul-smelling urine
- Pain or burning during urination
- Increased urgency or frequency
- Fever or chills
Preventing UTIs is crucial, and maintaining good bladder hygiene is one way to reduce risk. This includes:
- Emptying the bladder regularly: Following your voiding schedule can help prevent urine from sitting in the bladder for too long.
- Staying hydrated: Drinking water flushes out bacteria from the urinary tract.
- Using catheters properly: If catheterization is necessary, ensure that it is done in a sterile manner and follow your healthcare provider’s guidance for care and cleaning.
- Bladder Retraining
Bladder retraining involves gradually increasing the time between voiding to improve bladder capacity and control. This technique is particularly useful for individuals with overactive bladder (OAB), a common symptom of neurogenic bladder. By gradually stretching the intervals between bathroom visits, the bladder is trained to hold more urine, reducing urgency and frequency.
Bladder retraining should be done under the guidance of a healthcare provider or pelvic floor therapist, who can tailor the program based on your symptoms and progress.
- Use Incontinence Products as Needed
For those dealing with incontinence, it’s important to have the right products to help manage leakage and maintain confidence throughout the day. There are various types of incontinence products available, including absorbent pads, briefs, and protective underwear. Finding products that suit your needs can reduce anxiety and allow you to go about daily activities more comfortably.
It’s essential to remember that using these products doesn’t mean giving up on bladder control. They are tools to support your management plan while working on long-term improvements.
- Stay Physically Active
Regular physical activity supports overall health, including bladder function. Staying active can help maintain a healthy weight, which in turn reduces pressure on the bladder. However, some exercises, like high-impact activities (e.g., running or jumping), can worsen bladder leakage for individuals with neurogenic bladder.
Low-impact activities, such as walking, swimming, or yoga, are excellent options for staying active without putting undue stress on the pelvic floor muscles. Moreover, staying active can improve bowel function, preventing constipation and reducing bladder pressure.
Conclusion
Managing neurogenic bladder requires a comprehensive approach that includes medical interventions, therapies, and lifestyle modifications. As pelvic floor therapists, we empower our patients to take control of their symptoms through practical, daily strategies. By establishing a regular voiding schedule, managing fluid intake, practicing pelvic floor exercises, and being mindful of diet, individuals can significantly improve their bladder control and quality of life.
With consistent efforts and guidance from a healthcare professional, managing neurogenic bladder can become a more manageable part of daily life, allowing individuals to regain confidence and independence.
