urology Neurogenic bladder

The urinary bladder is muscular organ. Its muscle Detrusor,  should contract while voiding and releax rest of the time  while filling with urine. The brain and spinal cord regulates the bladder function. When ever there is a problem in this neuronal coordinated control of the bladder, its’ function is affected . This condition is known as neurogenic bladder.

What are the symptoms of neurogenic bladder?

The neurogenic bladder,  the patient  to lose control over the ability to urinate. It could cause you to urinate too much or not enough. Both of these could lead to harmful consequences. The symptoms of a neurogenic bladder include the following:

  • an inability to fully empty the bladder
  • a loss of control over the bladder like spontaneous voiding
  • a dribbling stream during urination
  • increased urinary tract infections (UTIs)
  • straining during urination
  • loss of sensation of fullness of bladder.
  • leakage of urine

It is advisable to visit the doctor if one or more of these symptoms start to surface.

What are the causes of a neurogenic bladder?

The nerves along the pathway between the brain and the bladder are disturbed for some reason.. The causes generally are brain disorders, spinal chord level or at bladder nerve damage. The disorders that can be responsible for a neurogenic bladder include:

Brain

  • Parkinson's disease
  • Alzheimer's disease
  • stroke
  • Cerebral atrophy
  • Tumors of the brain
  • Intra cranial bleed.
  • Hydrocephalus

Spinal

  • multiple sclerosis (a disease where the protective covering of the nerves is eaten away by the immune system)
  • injury to the spinal cord
  • compression of spinal chord by tumors or disc bulge
  • tumors in  the spinal cord
  • birth defects in the spinal cord like the spina bifida
  • Syringomyelia

The conditions that can affect the bladder muscle include the following:

  • pelvic surgery which might lead to nerve damage
  • diabetes, which can also result in nerve damage
  • Diabetic neuropathy

The bladder muscles and the nervous system is treated if the doctor thinks that you might be suffering from a neurogenic bladder.

What are the complications that can arise as a result of neurogenic bladder?

There are several complications related to this disorder. Since in this condition you to lose the bladder  sensation, the bladder can get filled beyond its capacity and start leaking. This  urinary retention  also causes back pressure on the kidneys and kidney function is lost slowly over a period of time Because of over contraction of the bladder muscle high pressure bladder is  created and thus  this high pressure can get transferred to kidneys and result in kidney damage.  Urinary retention would also increase the risk of infections in the urinary tract. Frequent infections in the kidneys and the urinary tract can lead to severe damage to renal system. This would ultimately lead to kidney failure, which would prove to be fatal.

How can a neurogenic bladder be treated?

Treatment of nuerogenic bladder is complex and long drawn. Aim of the therapy is to effectively completely evacuate the bladder, thus keep a low bladder presuure, prevent infection, preserve the functions of the kidneys.

The doctor might ask you to urinate at regular intervals or suggest therapies like Kegel exercises and the strengthening of the pelvic floor muscles. There are, however, several treatment methods available for a neurogenic bladder:

  1. Medication - Though there is no medication to treat neurogenic bladder, there are some that can enhance or reduce muscle contractions. Proper emptying of the urinary tract is ensured.
  2. Catheterization - The doctor might recommend using a catheter to ensure that the bladder can be fully emptied. However, the risk of UTIs is increased.
  3. CSIC:  clean  self intermittent catheterization. Patient can insert a catheter in to his bladder 4 to five times a day and evacuate the urine completely. Thus pressure on the upper tract is prevented and   kidney are preserved.
  4. Surgery - The doctor can insert an artificial sphincter into the body to compress the urethra to prevent urinary leakage. Bladder reconstruction surgeries can also be performed.
  5. Electrical stimulation therapy - The therapy involves placing small electrodes on the victim's bladder. The electrodes would send impulses to the brain when stimulated, giving you the signal that it is time to urinate.

Neurogenic bladder can be treated and if you any of the above symptoms, do not waste time and receive proper treatments soon.

Authored By : Dr. Mahendra Jain

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Dr. Mahendra Jain

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