Neurogenic Bladder - Causes and Signs of Neurogenic Bladder

Pathological conditions that are included in the concept of "neurogenic bladder" can be divided into several types:

• hyperactive bladder type;
• and hypoactive (sluggish).

Types of this disease can be distinguished based on the area of damage to the nervous system, due to which the pathology occurs:

• cerebral level;
• suprasacral;
• and directly sacral.

Causes

The basis of the disorder is neurological abnormalities at different levels. Let's consider the causes of this pathology within the framework of its individual types. Thus, the hyperactive form of the bladder as an element of the urinary system is provoked by disorders of the nervous system in the area above the pons of the brain. Thus, urine is not retained in the bladder, and as soon as it gets there, it immediately comes out in small volumes. The opposite form - hypoactive - is a consequence of lesions in the sacrum. The result is a violation of the contraction function of the bladder, due to which the innate reflex does not work at the right moment, and fluid accumulates in the bladder, stretching its size. After this, the sphincter loses the ability to hold urine, and incontinence occurs.

It is impossible to consider neurogenic bladder as a separate independent disease, since this syndrome is of a collective nature and implies serious disorders in the functioning of the urinary system. The primary causes of this pathology can be called:

• congenital defects in children;
• inflammatory diseases in the brain or spinal cord;
• degenerative diseases of the central nervous system (for example, diabetic neuropathy, multiple sclerosis);
• tumors of the central nervous system elements;
• various types of injuries.

It is worth noting that neurogenic disorders in the functioning of the bladder are often found in children, especially in girls. The seriousness is that the presence of such a pathology is a favorable environment for the development of many other diseases: cystitis, renal failure, etc.

Symptoms

In the case of a hyperactive and sluggish type of the disease, various symptoms are described. So, the hyperactive type is characterized by:

• a noticeable constant tension of the pelvic muscles;
• small volumes of urine excretion with very frequent urges;
• at night, the frequency of urges increases;
• pain may occur.

With a sluggish bladder, not only is the normal act of urination absent, but even the slightest urge to urinate does not arise. Against this background, so-called overflow incontinence develops. Symptoms of the hypoactive type of pathology include:

• a clear feeling of fullness of the bladder, but no urge;
• pain;
• during urination, the stream is constantly weak;
• development of dysfunction of the sphincter of the bladder.

The pathological condition can be of two extreme natures - either urinary incontinence, or, conversely, its prolonged retention.

Diagnostics

As in other cases, a mandatory stage of diagnosing the disease is the collection of complaints and a general examination by a nephrologist. Next, a number of laboratory and instrumental studies are prescribed:

• general blood test and biochemistry test;
• urine analysis;
• urethrocystography;
• ultrasound of the bladder;
• survey urography;
• video urodynamic studies.

Treatment

Treatment of this pathology necessarily requires establishing and eliminating the cause. In addition to drug treatment of the underlying disease, a set of measures is also carried out to restore normal bladder function. In difficult cases, it is necessary to resort to catheterization or surgical intervention. With the right and prompt approach, the prognosis for the treatment of this disease is favorable.

Prevention

If a person has a predisposition to the development of this disease, then uroseptics in small doses can be prescribed for preventive purposes. Also, timely treatment of emerging diseases of the central nervous system can be considered as preventive measures.