Urinary system involves nerves and organs coordinated with the brain and spinal cord. Communication breakdown can lead to issues.
KNOWLEDGE CENTRE
CONTINENCE CARE
NEUROGENIC BLADDER
The spinal cord injury as well as diseases such as multiple sclerosis and congenital conditions as spina bifida can cause neurogenic bladder. Since it is a bladder dysfunction,
it is necessary to have a proper treatment.
WHAT IS A NEUROGENIC BLADDER?
Neurogenic bladder is a bladder dysfunction caused by a disorder in the functioning of the nervous system part associated with the process of urine excretion. Essentially, it is the inability of the bladder the function properly.
SYMPTOMS AND CONSEQUENCES
In order for the urinary system to function properly, it is necessary that the nerves, certain muscles and the brain work together. In the case of nerve damage, it will lead to a disturbance in their functioning, and therefore negatively affect the work of the muscles necessary for the proper functioning of the urinary system.
In clinical terms, the most common consequences and symptoms of the neurogenic bladder are
- inability to control urination and urine retention (incontinence)
- inability to fully empty the bladder (retention)
frequent inflammations of the urinary tract
DIAGNOSIS AND TYPES OF NEUROGENIC BLADDER
In addition to a physical examination by a doctor, the “gold standard” for the diagnosis of neurogenic bladder is the urodinamic test.
It generally identifies potential disorders in the lower urinary tract, the causes and location of these disorders, the functionality of the bladder and urethra (urinary tubes) and the ability to retain urine and urinate.
TYPES OF NEUROGENIC BLADDER
In case the bladder contracts uncontrollably and empties when it is full, we are talking about an overactive bladder. If the bladder is not emptied when it is full, it is called a loose bladder. These differences can be illustrated with an example of the spinal cord injury. If the bladder is preserved (injury above T12), it will be contracted for the purpose of emptying when it is full. When this reflex is not active (probably in injuries below L1), the bladder will not contract for emptying even when it is full.
As a rule, both types of neurogenic bladder need to be treated to protect your health, avoid these consequences, and establish a urination rhythm that suits your lifestyle.
TREATMENT OF NEUROGENIC BLADDER
The treatment is individualised and depends on several factors
- type and level of injury (in the case of SCI)
- type of bladder dysfunction
- motor/cognitive skills
Numerous studies have determined the positive effects of intermittent catheterisation as a treatment of neurogenic bladder and a significant contribution of this technique to the quality of life of a person with SCI.
Various types of intermittent catheters are available, made of different materials. Studies have shown a higher level of user satisfaction in people who use hydrophilic catheters compared to other conventional catheters.
Intermittent catheterisation is performed every 4-6 hours, thus establishing a routine and imitating the natural rhythm of bladder discharge.
There is also an option of using permanent and suprapubic catheters where intermittent catheterisation is not possible. For example, permanent catheters are used in the weeks following the injury. The men whose reflex is preserved can use a urinary condom that collects urine in addition to intermittent catheterisation.
Neurogenic bladder can also be treated by taking medicines such as anticholinergics (bladder with a reflex). This medicine is also commonly used in combination with intermittent catheterisation to relax the bladder and avoid incontinence. In case the conservative methods in the treatment of neurogenic bladder are not successful, surgical procedures are also possible.
