Neurogenic Detrusor Overactivity

A Multidisciplinary Treatment Approach

Normally the bladder stores urine at a low pressure. When the bladder is full, pressure in the urethra drops, the sphincter muscle at the bladder exit relaxes and the detrusor (bladder) muscle contracts to release urine. This process, and the series of muscle contractions and relaxations involved, is regulated by the nervous system. In a healthy individual, the brain sends messages to the bladder to turn urination on and off.

Urinary incontinence due to detrusor overactivity associated with a neurologic condition, such as multiple sclerosis (MS) or spinal cord injury (SCI), results when the spinal cord and bladder do not communicate effectively. For people living with MS, this occurs because they develop lesions on the spinal cord, while people with SCI have irreversible nerve damage, resulting in the inability of the spinal cord and bladder to communicate effectively. As a result, the bladder muscle involuntarily contracts, increasing the pressure in the bladder and decreasing the volume of urine the bladder can hold, which causes the individual to leak urine frequently and unexpectedly.

Treatment for NDO

A multidisciplinary treatment approach can be helpful for MS and SCI patients with urinary incontinence due to neurological detrusor overactivity. Physicians with differing medical specialties may be involved in caring for these patients, often including a neurologist to manage the underlying nerve damage or degeneration and a urologist to manage the resulting urinary incontinence.