Neurogenic bladder, alternatively known as neurogenic lower urinary tract dysfunction, is a problem that occurs when a person lacks bladder control due to a brain, nerve, or spinal cord problem. Several nerves and muscles must work together for the bladder to hold urine until the person is ready to empty it. The nerves carry messages between the bladder and brain and spinal cord. The messages communicate with the muscles of the bladder to either tighten or release. If the nerve are damaged by injury or illness, then the muscles may not be able to tighten or relax at the correct time. For people with neurogenic, bladder, the nerves and muscles do not communicate properly. As a result, the bladder may not fill or empty in the correct way. The bladder may begin to empty itself before the person reaches the bathroom – this is known as overactive bladder. If the bladder cannot empty completely, a person may experience leakage, known as overflow incontinence. The sphincter controlling the bladder may not work, known as stress incontinence. The person may also experience bladder symptoms that cause the bladder to shrink before the person reaches the toilet, known as urge incontinence.
Neurogenic bladder often is caused by disorders of the central nervous system. Examples of such conditions are stroke, spinal cord injury, Multiple Sclerosis (MS), Parkinson’s disease, cerebral palsy, encephalitis, Alzheimer’s disease, birth defects of the spinal cord such as spina bifida, sacral agenesis, spinal cord or brain tumors, heavy metal poisoning, central nervous system tumors, erectile dysfunction, heavy metal poisoning, or learning disabilities such as attention deficit hyperactivity disorder (ADHD). Neurogenic bladder can also occur when a person experiences damage or disorders of the nerves that supply the bladder. Examples of such conditions include nerve damage, also known as neuropathy; nerve damage due to long term diabetes; vitamin B12 deficiency; nerve damage due to pelvic surgery; or nerve damage from a herniated disc or spinal canal stenosis. Symptoms of neurogenic bladder can vary, based on the cause. Symptoms of overactive bladder can include loss of bladder control, issues with emptying all of the urine from the bladder, and having to urinate too frequently in small amounts. Symptoms of an underactive bladder can include an inability to tell when the bladder is full, a full bladder and possible urine leakage, and problems starting to urinate or emptying all of the urine from the bladder, also referred to as urinary retention. Other common symptoms of neurogenic bladder include frequent urinary tract infections, or UTIs; dribbling urine; small urine volumes during voiding; painful urination; and kidney stones. There are a number of ways in which a healthcare provider may diagnose neurogenic bladder. These tests may include urodynamic studies, cystoscopy, X-rays, CT scans, or MRIs. Urodynamic studies are bladder function tests which measure how much urine the bladder can hold, the pressure within the bladder, how well urine flows, and how well the bladder empties when it is full. Special sensors may be placed on the skin near the urethra or rectum to determine if the muscles and nerves in these parts of the body are functioning properly. A cystoscopy may be performed by a doctor to examine the inside of the bladder and urethra with the use of a small telescope, referred to as a cystoscope. The cystoscope is a thin, flexible tube and viewing device that allows the healthcare provider to examine the urinary tract for structure changes or blockages such as tumors or stones.
Neurogenic bladder can be treated in a number of ways. The treatment of neurogenic bladder will depend on the cause, and is aimed at preventing kidney damage. These treatment methods can include medications, emptying the bladder with a catheter at regular intervals – known as catheterization or “cathing,” preventative antibiotics to reduce infection, surgery to remove any stones or blockages, Botox injections into the bladder muscle, placement of an electrical device to stimulate or slow down bladder activity, or placing an artificial cuff around the neck of the bladder. The artificial cuff around the neck of the bladder can be inflated to hold urine and deflated to release urine.
The symptoms of and treatment for neurogenic bladder can certainly cause major disruptions in one’s daily life, including one’s ability to perform normal work activities. If you are suffering from the effects of neurogenic bladder and unable to work, you may qualify to receive Social Security disability benefits. The legal team at LaBovick Law Group is ready to assist you with your claim for Social Security disability benefits.
Social Security follows a 5 step process when evaluating disability claims. First, Social Security will confirm that you have not engaged in “substantial gainful activity” since the date of disability. If you have stopped working due to your medical conditions, you will meet this criterion. Second, Social Security will determine whether you have a medically determinable impairment. Suffering from neurogenic bladder would satisfy this criterion. To establish that you have a medically determinable impairment, you would need to have medical records from your providers, including visit notes with the doctor’s comments as well as diagnostic testing. If you underwent urodynamic testing, for example, these results would be needed to prove the severity of your condition. Social Security then will determine your residual functional capacity. This is an assessment of your ability to perform sustained work related physical and mental activities in a work setting on a regular and continuing basis. For example, if prolonged walking or lifting weight exacerbates your condition and causes bladder leakage or urgency, this would be factored into your residual functional capacity. Another component would be “off task” behavior such as needing to use the restroom more frequently due to your condition. Social Security will then determine whether you can return to your past work in light of your functional capabilities. If you are not able to return to your past work, Social Security will determine whether there are other jobs which you would be able to perform with your limitations. If not, you will be found disabled.
If you are struggling with working due to symptoms or treatment related to neurogenic bladder, it is best to consult with an attorney to determine whether Social Security Disability is the right choice for you. Give us a call at (561) 625-8400 for a free case evaluation.