Neurogenic bladder – this organ pathology, which is associated with some dysfunction of the nervous system. This is one of the most common conditions in which there is no possibility to accumulate the urine, and its secretion occurs by itself.
Why do I get
Neurogenic dysfunction of the bladder in adults is most likely to occur when injuries or lesions of the brain or spinal cord. This is mainly stroke, compression, surgery, fractures of the spine. Also, the cause could be encephalitis, encephalomyelopathy, polyneuropathy, polyradiculoneuritis, and some other diseases of degenerative character.
In children, this pathology appears for other reasons. It is a congenital defect of the Central nervous system, spine or urinary system, what happens after receiving birth trauma.
Most often the disease is manifested in women. It can be of a permanent nature, and also appear periodically or sporadically. Symptoms have this disease a huge number, and it all depends on the level of the lesion.
The main symptoms is considered to be frequent night urination, incontinence, urgent need. All this leads to increased pressure inside the bladder, and the amount of urine is minimal. This also should be attributed to weakness of the sphincter, and frequent urination.
The symptoms are also includes such as when emptying occurs if you accumulate less than 250 ml of urine. Also there is difficulty beginning urination. To others, not as significant symptoms that can include sweating, pressure rise, increasing spasticity.
Urination can happen in case of an accidental irritation of the thighs or the area above the pubis. When combined with some neurological lesions can occur from involuntary release of large amounts of urine.
In men, the disease is diagnosed less frequently, but the reasons here are the most serious, so this condition feels much harder. In children this condition also occurs in one or another scheme.
These symptoms relate to an overactive form of disease. There is another form, which is called hypoactive, and there manifestations are quite different.
Neurogenic bladder is neurological in this case, manifests a complete lack of contractility and emptying. Herewith, the bladder may even be crowded. Here is not developing high intravesical pressure, which leads to a complete lack of urine output or lethargic urinate. The residual amount of liquid may exceed 400 ml, and one does not feel that he was devastated. Can happen another condition with a full bladder mechanically stretches the inner sphincter, and the urine drops or minimal servings comes out.
How to get rid of
The treatment is performed by a urologist and a neurologist simultaneously. Begins therapy with the minimum of trauma methods. The hyperactive type is treated faster and easier. The main drugs – those that reduce increased muscle tone, eliminate hypoxia and improve circulation.
Lately this pathology in women treated with botulinum toxin, which is injected into the bladder wall. For additional therapy, use drugs succinic acid, L-carnitine, vitamins, medication, which have strong antioxidant action.
Be sure to use non-pharmacological treatment – electrical stimulation, laser therapy, ultrasound, heat application, normalization of sleep and drinking regimen, psychotherapy. Treatment in children is virtually identical to that used in the treatment of adults. The only difference is the minimum possible dose of medicines.
Hypoactive form of therapy lends itself not so well. Since some amount of urine is constantly in the bubble, then it is a big risk for developing a variety of infectious conditions, including cystitis or pyelonephritis. Therefore, it is very important to ensure complete emptying. In the most severe cases may require a permanent catheter.
Treatment of neurogenic bladder dysfunction in children and adults, includes drug therapy with cholinomimetics, alpha-blockers, sympathomimetics.
For prevention of bladder infections is used control over the amount of residual urine and required the use of antibiotics.
At surgery, resection of the sphincter that allows you to completely empty your bladder when pressing on lower abdomen. With proper and timely treatment to avoid all possible complications, as well as in the future will be able to give up total surgery.