Neurogenic Bladder Treatment India
The normal function of the bladder is to store and expel urine in a coordinated, controlled fashion. This coordinated activity is regulated by the central and peripheral nervous systems. But what happens when the bladder malfunctions as a result of dysfunction, trauma, disease or injury? The information below should help you recognize this problem before it causes serious damage.
What happens under normal conditions?
The urinary bladder, a spherical organ, has a soft inner lining (similar to the inner cheek) and an outer muscle layer. In addition to the bladder, the bladder neck (funnel-like outlet of the bladder which leads to the urethra), the urethra (tube-like structure which serves as a channel to carry urine from the bladder to the external surface) and the external urethral sphincter muscle (group of muscles which surround the urinary passage below the bladder neck) complete the lower urinary tract.
The muscles and nerves of the urinary system must function in a coordinated fashion with the bladder in order to perform its two major functions of storage and elimination of urine. Nerves carry messages from the bladder to the brain and then from the brain to the muscles of the bladder telling them to either tighten or release, allowing the bladder to empty during urination.
What is Neurogenic Bladder?
Neurogenic Bladder is the loss of normal bladder function caused by damage to part of the nervous system. The damage can cause the bladder to be underactive, in which it is unable to contract and unable to empty completely, or it can be overactive, in which it contracts too quickly or frequently.
What are some risk factors for Neurogenic Bladder?
Risk factors for Neurogenic Bladder include various birth defects, which adversely affect the spinal cord and function of the bladder, including spina bifida and other spinal cord abnormalities. Tumors within the spinal cord or pelvis may also disrupt normal nervous tissue function and place an individual at risk. Traumatic spinal cord injury is also a major risk factor for development of Neurogenic Bladder.
What are the symptoms of Neurogenic Bladder?
Inability to control urination, also known as urinary incontinence, is perhaps the most common symptom associated with the Neurogenic Bladder. This may be caused by abnormalities in bladder capacity or malfunction of control mechanisms such as the bladder neck and/or external urethral sphincter muscle that are important for the bladder's storage function.
Symptoms including a dribbling urinary stream, straining during urination or inability to urinate may also be associated with Neurogenic Bladder. Urinary retention may result either from loss of bladder muscle contracting performance or loss of appropriate coordination between the bladder muscle and the external urethral sphincter muscle.
Irritating symptoms, such as urinary frequency and urgency, may be evidence of bladder hyperactivity. Other irritating symptoms may include painful urination (dysuria), which may be a result of a urinary tract infection (UTI) caused by urine being held too long in the bladder. UTI with fever is a sign of potential severe kidney infection (pyelonephritis) and is a more worrisome situation as it may result in permanent damage of the kidney(s).
Stones may also form in the urinary tract of individuals with a Neurogenic Bladder caused by the stoppage of urine flow and/or infection.
Abnormal backup of urine from the bladder to the kidney(s), also known as vesicoureteral reflux (VUR), may develop as a means of releasing high pressure within the bladder. A UTI is of particular concern as VUR may place the patient at significant risk for a severe kidney infection by transporting infected bladder urine directly to the kidney(s).
How is Neurogenic Bladder diagnosed?
When Neurogenic Bladder is suspected, both the nervous system (including the brain) and the bladder itself are tested. In addition to complete medical history and physical examination, diagnostic procedures may include:
X-rays of the skull and spine
An electroencephalogram (EEG) to identify brain dysfunction
Imaging tests of the bladder and ureters
Function tests that involve filling the bladder to see how much it can hold and if it empties completely