Understanding Your Child’s Condition

Brain-Bladder Communication

Understanding Pediatric Overactive Bladder
Caused by a Neurologic Condition (OAB-NC)

OAB-NC results from damage to the nervous system
that impacts bladder and urination.

The need for treatment

Children with nerve dysfunction or damage, as in conditions such as spina bifida or spinal cord injury, often have problems controlling their bladder.

This means the child may:

  • Have nerves connecting the brain and the bladder that do not work properly
  • Experience trouble storing urine in the bladder, controlling the voluntary emptying of the bladder, or both

Have questions about BOTOX® for OAB-NC?

See the FAQs

Over 90% of people with spina bifida
experience symptoms of OAB-NC (n = 1989).

 

The majority of children with spina bifida require some
type of intervention to recognize when they have to
urinate and also to avoid urine leaks.

90%

Children with spinal cord injuries may experience urinary tract complications

Many children with spinal cord injuries also require treatment for their bladder in order to store more urine and empty when needed.

Brain-Bladder Communication

When urine in the bladder reaches a certain level, the bladder sends a message
to the brain, and your child feels the urge to “go.” At that point, children with a
healthy bladder can choose to empty the bladder when they’re ready. The brain
then sends a message back to the bladder to urinate. Here’s how it happens:

Bladder fills up and
stores urine

While the bladder is filling up, the bladder muscle relaxes to store the urine while the sphincter muscles in the urethra contract (tighten) to prevent leakage of urine.

Bladder stretches

As the bladder fills up, it stretches. Nerves in the bladder sense that the bladder is getting full and send out a message to the brain.

Spinal cord carries message to brain

The spinal cord carries this message from the bladder to the brain.

Brain knows the bladder is full

The brain gets the signal that the bladder is becoming full, and a person feels the urge to "go." Usually, the brain can control this urge, and the person chooses to go to the bathroom when they are ready.

Brain sends message to bladder

The brain sends a message back to the bladder telling the bladder muscle to contract and the sphincter muscles in the urethra to relax.

Urination occurs

The person can go to the bathroom when and where they choose.

Bladder fills up and
stores urine

While the bladder is filling up, the bladder muscle relaxes to store the urine while the sphincter muscles in the urethra contract (tighten) to prevent leakage of urine.

Bladder stretches

As the bladder fills up, it stretches. Nerves in the bladder sense that the bladder is getting full and send out a message to the brain.

Spinal cord carries
message to brain

The spinal cord carries this message from the bladder to the brain.

Brain knows the
bladder is full

The brain gets the signal that the bladder is becoming full, and a person feels the urge to "go." Usually, the brain can control this urge, and the person chooses to go to the bathroom when they are ready.

Brain sends message
to bladder

The brain sends a message back to the bladder telling the bladder muscle to contract and the sphincter muscles in the urethra to relax.

Urination occurs

The person can go to the bathroom when and where they choose.

Injuries to the brain or spinal cord can
interfere with these messages and cause the
bladder muscle to become overactive.

Bladder muscle overactivity can cause the bladder to
contract (tighten) involuntarily when it should be relaxed.
This can lead to leakage of urine, or urinary incontinence.

Understanding How Your Bladder Works

Normal Bladder Storage

Here’s what happens during storage in a bladder that is not overactive:

Click each number for more details

The bladder muscle relaxes to allow the bladder to store urine.

The bladder fills with urine.

The sphincter muscles contract (tighten) to close the urethra and prevent urine leakage.

The bladder muscle relaxes to allow the bladder to store urine.

The bladder fills with urine.

The sphincter muscles contract (tighten) to close the urethra and prevent urine leakage.

During emptying, the bladder muscle contracts, increasing pressure inside the bladder. At the same time, the sphincter muscles relax, allowing urine to flow out.

Urine Leakage (Incontinence) Due to a Neurologic Condition

Here’s why a neurologic condition can cause an overactive bladder that can lead to urinary incontinence:

Click each number for more details

Because the bladder cannot communicate with the brain, the bladder muscle may become overactive and contract (tighten) involuntarily.

Bladder pressure increases even when the bladder is not full.

Bladder capacity decreases and cannot hold as much urine.

Urine leakage (urinary incontinence) may occur.

Because the bladder cannot communicate with the brain, the bladder muscle may become overactive and contract (tighten) involuntarily.

Bladder pressure increases even when the bladder is not full.

Bladder capacity decreases and cannot hold as much urine.

Urine leakage (urinary incontinence) may occur.