Complications
Neurogenic bladder can cause hydronephrosis (swelling of a kidney due to a build-up of urine), recurrent urinary tract infections, and recurrent kidney stones which may compromise kidney function. This is especially significant in spastic neurogenic bladder that leads to high bladder pressures. Kidney failure was previously a leading cause of mortality in patients with spinal cord injury but is now dramatically less common due to improvements in bladder management. Causes
Urine storage and elimination (urination) requires coordination between the bladder emptying muscle (detrusor) and the external sphincter of the bladder. This coordination can be disrupted by damage or diseases of the central nervous system, peripheral nerves or autonomic nervous system. This includes any condition that impairs bladder signaling at any point along the path from the urination center in the brain, spinal cord, peripheral nerves and the bladder. Central nervous system
Damage to the brain or spinal cord is the most common cause of neurogenic bladder. Damage to the brain can be caused by stroke, brain tumors, multiple sclerosis, Parkinsons disease or other neurodegenerative conditions. Bladder involvement is more likely if the damage is in the area of the pons. Damage to the spinal cord can be caused by traumatic injury, demyelinating disease, syringomyelia, cauda equina syndrome, or spina bifida. Spinal cord compression from herniated disks, tumor, or spinal stenosis can also result in neurogenic bladder. Peripheral nervous system
Damage to the nerves that travel from the spinal cord to the bladder (peripheral nerves) can cause neurogenic bladder, usually the flaccid type.
There is not yet sufficient evidence on how effective this combined pentavalent vaccine is in relation to the individual vaccines. References
Further reading
Ramsay M, ed. (2013). "Chapter 16: Haemophilus influenzae type b (Hib)". Immunisation against infectious disease. Public Health England. External sources
"Haemophilus Influenzae Type b (Hib) Vaccine Information Statement". U.S. Centers for Disease Control and Prevention (CDC). 10 August 2021. "Haemophilus B Conjugate Vaccine (Meningococcal Protein Conjugate)". U.S. Food and Drug Administration (FDA). 24 April 2019. "Haemophilus b Conjugate Vaccine (Tetanus Toxoid Conjugate)". U.S. Food and Drug Administration (FDA). 24 April 2019. "Hiberix". U.S. Food and Drug Administration (FDA). 3 October 2019.