Overactive (reflex) bladder
When the bladder muscles contract spontaneously as it begins to fill with urine, causing incontinence (i.e. accidental emptying) because the person is unaware of when the emptying will occur.
Underactive (flaccid) bladder
When the bladder can’t release urine because it tends to lose muscle strength and cannot contract properly for emptying. Without appropriate management, a flaccid bladder is at risk of overstretching and becoming damaged or infected because the person may be unable to feel when the bladder is full. Bacteria, therefore, will not be removed through urination and can spread into the bladder.
Some people may have ‘mixed bladder’ nerve damage. This means that the bladder may act like a flaccid bladder or a reflex bladder and may, therefore, have more varied and unpredictable symptoms.
The symptoms of a neurogenic bladder must be properly managed. If the bladder has lost its inherent ability to empty, the preferred method is intermittent catheterization.
These are general guidelines meant to help you with typical questions. You should follow the specific instructions provided by your healthcare provider and the intermittent catheterization solution you are using.