Living with VACTERL Association

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Neurogenic Bladder in People with Anorectal Malformations 

Neurogenic bladder means the bladder does not store or empty urine properly because the nerves that control it are not working correctly.

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In people with Anorectal Malformations, bladder problems can occur because the rectum, anus, bladder, and pelvic floor muscles develop at the same time in early pregnancy and share nerve supply from the lower (sacral) spinal cord. If development in this area is affected, both bowel and bladder control may be impacted.

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Some people with ARM also have spinal differences such as:

• Tethered spinal cord

• Sacral (lower spine) abnormalities

• Other spinal cord malformations

These conditions can interfere with the nerves that control bladder function.

 

Pelvic Muscle Dysfunction:

Even if the nerves are intact, the pelvic floor muscles may not coordinate properly, which can affect bladder emptying and urine control.

Protecting kidney function is the most important treatment goal.

 

Neurogenic bladder

This varies from person to person, some people can have a combination of both, but it usually falls into two patterns:

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Overactive Bladder - The bladder empties too often or at the wrong time.

Symptoms may include:

• Frequent urge to urinate

• Leakage or accidents

• Small bladder capacity

• High bladder pressures
   

Underactive Bladder - The bladder does not squeeze effectively.

Symptoms may include:

• Difficulty starting urine

• Weak urine stream

• Incomplete emptying

• Urinary retention

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If left untreated, neurogenic bladder can lead to:

• Recurrent urinary tract infections (UTIs)

• Kidney damage

• Bladder overstretching

• Ongoing incontinence

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