Neurogenic Bladder: Why Do I Need a Urologist?

Neurogenic Bladder: Why Do I Need a Urologist?


When a person has a spinal cord injury, it is very likely that their bladder will not work normally. A urologist is a medical doctor who specializes in treating conditions that affect the urinary tract, including the bladder.

Everyone with a new spinal cord injury needs to see a urologist after leaving their rehabilitation hospital. Since neurogenic bladder is a chronic condition (meaning it is ongoing), a urologist will always be an important part of your health care team. 

The urologist will help you: 

  • Create a bladder management program that works best for you 
  • Prevent and treat infections 
  • Keep your kidneys safe 

Your first evaluation 

When some time has passed after your injury and your spinal shock has resolved (the period of time after your injury when you do not have any reflexes), you will need to have tests done to assess the health of your bladder and kidneys, called urodynamics. 

During the urodynamics test, your bladder will be filled by a very small catheter. Your bladder function will be monitored to understand how your bladder works. The test looks for:

  • How much your bladder holds
  • Spasms or leaks
  • Elevated pressure in the bladder, which may cause urine to back up to the kidneys

The urologist may adjust your bladder program based on your results. 

If you develop problems later, the test may need to be repeated. It is also a good way to check the health of your bladder.

You may also have these tests: 

  • Kidney ultrasounds 
  • Kidney function testing (blood work) 
  • Exams and urine samples

Bladder management 

For most people with spinal cord injury, options for bladder management include:

  • Clean intermittent catheterization 
  • Indwelling catheter
  • Voiding/condom catheter
  • Surgery

Your urologist will discuss each of these with you to help you choose which option is best. Regardless of how you decide to manage your bladder, your urologist can help keep you safe. 

Call your urologist if you have: 

  • Have urinary tract infections (UTIs) often
  • New bladder leaks 
  • Fever or pain in your side due to UTIs
  • Blood in your urine 
  • Trouble with your catheter 

Follow up 

The American Urological Organization recommends that people with spinal cord injury and neurogenic bladder are followed closely by their urologist. This includes: 

  • A visit with your urologist every year 
  • A kidney ultrasound every 1 to 2 years 
  • A kidney function test (blood work) every year 


Sources: 

  • Ginsberg DA, Boone TB, Cameron AP et al: The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation. J Urol 2021; 206: 1097.
  • Ginsberg DA, Boone TB, Cameron AP et al: The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Treatment and Follow-up. J Urol 2021; 206: 1106.


© 2022 – August 5, 2022, The Ohio State University Wexner Medical Center

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. For more health information, call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.