Neurogenic Bladder

What is Neurogenic Bladder?

A person with neurogenic bladder, often referred to as neurogenic lower urinary tract dysfunction, is unable to regulate their bladder as a result of neurological, spinal cord, or brain issues. Your bladder needs to cooperate with a number of muscles and nerves in order to hold pee until you’re ready to empty it. The brain and the muscles that regulate when the bladder empties exchange nerve signals. The muscles might not be able to contract or relax at the appropriate times if these nerves are damaged by disease or trauma. Nerves and muscles do not cooperate properly in patients with neurogenic bladder and neurogenic lower urinary tract dysfunction. It’s possible that the bladder won’t fill or empty properly.

What are the Symptoms?

Individuals with neurogenic bladder experience different symptoms. The sort of nerve injury producing the issue also affects the symptoms. Bladder muscles that are hyperactive and squeeze more frequently than usual might cause incontinence. Urine may occasionally leak as a result of this squeezing before you are ready to pass it. Overactive Bladder (OAB): OAB causes an abrupt urge to urinate. Some people leak urine—a few drops or a large volume—after experiencing this sensation. Urinating more than eight times in a 24-hour period is another indication.

Underactive Bladder: With underactive bladder symptoms, you may only dribble a bit of urine. You may not be able to empty your bladder fully or may not be able to empty your bladder at all.
Some people have symptoms of both overactive and underactive bladder. Those with MS, stroke and spinal cord injury are more likely to have both kinds of symptoms. People who suffer from both overactive and underactive bladder may have many urinary tract infections (UTI). UTIs are often the first sign of neurogenic bladder.

How is Neurogenic Bladder Diagnosed?

The neurological system and the bladder are both involved in neurogenic bladder, therefore your doctor may do a number of tests to assess both. A crucial first step may be discussing your symptoms with your physician. Your doctor might inquire about your daily routine and medical history. In order to help diagnose your issue, doctors may occasionally advise you to keep a bladder diary or use an assessment tool. Additionally, you might be requested to do a pad test. This involves donning a pad that has been coated with a unique dye, which changes color in response to pee leaks. Physical examinations could also be required. The doctor may examine a woman’s rectum, pelvic, and abdomen. Men may have their prostate, rectum, and abdomen examined. Urodynamic testing to assess the function of your urinary tract or a urine test to check for infections are examples of further tests. A scan or x-ray could also aid in your diagnosis.

How is Neurogenic Bladder Treated?

When neurogenic bladder is watched closely and treated, patients can see large improvements in their quality of life. Some ways to manage neurogenic bladder may include:
Lifestyle Changes
Lifestyle modifications, often known as behavioral therapy, may be a helpful initial step for people with less nerve damage. These are lifestyle adjustments that people can adopt to manage their symptoms. The following are some lifestyle modifications for neurogenic bladder: Scheduled voiding can increase the amount of time you can hold your pee by trying to hold it and passing it at certain periods rather than when you first feel the urge. In certain situations, your doctor might advise you to attempt emptying your bladder at regular intervals by using the restroom, even if you don’t feel the need to. Limit certain foods and beverages: Research has shown that several foods and beverages can irritate the bladder. Coffee, tea, colas, and spicy foods have all been reported to irritate some people. Trying to observe how food and beverages impact you and your symptoms may be very beneficial. Double voiding: This technique may be useful for people who have a persistent urge to void after passing urine or who truly struggle to empty their bladder. Double voiding involves waiting a few seconds to a minute after passing pee, then relaxing and attempting to empty your bladder of any remaining urine. Delaying urine for a few minutes is the first step if you experience signs of OAB. You gradually extend it to a few hours. This teaches you how to resist the need to void even when it arises. Exercises for the pelvic floor: These can strengthen your sphincter muscles or help you relax your bladder muscle when it first contracts.
Medical Treatments
When lifestyle changes do not help enough, your doctor may ask you to try some other choices, such as prescription drugs or catheters.
OAB drugs can help to relax overactive bladder muscles. These may be taken by mouth, or delivered through the skin with a gel or a patch.
 

For underactive bladders, catheters are frequently utilized. To aid in the complete emptying of your bladder, this little tube is placed into your urethra. Two varieties exist. Urine is constantly drained using a continuous catheter. To empty your bladder, you insert an intermittent catheter several times a day. For certain people with hand coordination issues, intermittent catheterization may be challenging. Additional therapies could involve electrical nerve stimulation, botulinum toxin injections, or surgery. The cause of your nerve injury and your symptoms will determine the available therapy options. To determine the best course of action for managing your symptoms, see your healthcare professional. Seeing a specialist who specializes in neurogenic bladder, like a urologist or neurologist, may also be very beneficial.

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