Neurogenic bladder refers to what happens when the relationship between the nervous system and bladder function is disrupted by injury or disease. It cannot be cured but can be managed. Treatment options include medications, use of catheters and lifestyle changes.
This nerve damage can be the result of diseases such as multiple sclerosis (MS), Parkinson's disease or diabetes. It can also be caused by infection of the brain or spinal cord, heavy metal poisoning, stroke, spinal cord injury, or major pelvic surgery.
The symptoms of neurogenic bladder differ from person to person. They also depend on the type of nerve damage the person has. Symptoms may include urinary tract infections, kidney stones and not being able to control how many times you urinate, when you urinate or how much you urinate.
Medicine for Neurogenic Bladder
Your health care provider may suggest: Overactive bladder medicines that relax the bladder such as oxybutynin, tolterodine, or solifenacin, as well as mirabegron. Bladder muscle injections to relax the bladder, such as injection of Botulinum toxin.
Small urine volume during voiding. Urinary frequency and urgency. Dribbling urine. Loss of feeling that the bladder is full.
Sometimes a section of a nerve is cut completely or damaged beyond repair. Your surgeon can remove the damaged section and reconnect healthy nerve ends (nerve repair) or implant a piece of nerve from another part of your body (nerve graft). These procedures can help your nerves regrow.
The life expectancy of patients in the VS ranges from 3 to 5 years [6].
It is important to treat neurogenic bladder to prevent kidney damage due to urinary problems. If neurogenic bladder goes untreated, a patient might develop renal disease. People with renal disease may require dialysis or a kidney transplant.
Pelvic parasympathetic nerves: arise at the sacral level of the spinal cord, excite the bladder, and relax the urethra. Lumbar sympathetic nerves: inhibit the bladder body and excite the bladder base and urethra.
The bladder can regenerate like nobody's business and now we know why. The bladder is a master at self-repair. When damaged by infection or injury, the organ can mend itself quickly, calling upon specialized cells in its lining to repair tissue and restore a barrier against harmful materials concentrated in urine.
The sympathetic innervation of the bladder originates in the lower thoracic and upper lumbar spinal cord segments (T10-L2), the preganglionic axons running to sympathetic neurons in the inferior mesenteric ganglion and the ganglia of the pelvic plexus.
Injury to the bladder from a bullet or other penetrating object is usually fixed with surgery. Most of the time, other organs in the area will be injured and need repair as well. After surgery, a catheter is left in the bladder to drain the urine and blood until the bladder heals.
Approximately 85% of such injuries will heal within 7 to 10 days, at which point the catheter can be removed and a trial of voiding completed. Overall, nearly all extraperitoneal bladder injuries heal within 3 weeks.
If your healthcare provider thinks the urinary problem is related to nerve or muscle damage, they will order an electromyogram. Electromyography uses sensors to measure the electrical activity of the muscles and nerves in and around the bladder and the sphincters.
Bladder augmentation - Enterocystoplasty
The surgical bladder augmentation is indicated for the treatment of neurogenic detrusor overactivity when the intravesical botulinum toxin injection fails or in cases of low bladder compliance.
Left untreated, neurogenic bladder can cause severe, even life-threatening, kidney damage. Fortunately, many effective options are available to help with both medical and quality-of-life concerns.
Uninhibited neurogenic bladder is most often associated with a stroke, brain tumor, spinal lesion, Parkinson or a demyelinating disease are the most common causes. Symptoms are typically frequency, urgency, and urge incontinence.
Diane Newman, adult nurse practitioner and a continence nurse specialist in urology outlines four types of neurogenic bladder disorders: atonic bladder, hyper-reflexive bladder, uninhibited bladder, and sensorimotor paralytic bladder.
To find out, conclusively, if your nerves are damaged, you need to see a neurologist. He or she will perform tests to determine the health of your muscles and nerves. If there is a problem, the doctor will explain the reason for the damage and its extent. They will follow up by devising a treatment plan.
Anticonvulsant drugs (AEDs) that have shown promise in several include oxcarbazepine, zonisamide, topiramate, levetiracetam, and lamotrigine. These results may be due to their GABA effects. These agents are most helpful clinically in the signs and symptoms of radiculopathic and neuropathic pains and paresthesias.