Neurogenic bladder: symptoms and treatment
Neurogenic bladder — a violation in the functioning of the bladder, which is caused by a malfunction in the nervous system. It should be noted that the same term can be used to refer to other ailments with a similar clinical picture. The ailment can almost equally be found in both women and men.
Clinicians point out that the neurogenic bladder is not an independent disease. As a rule, this syndrome is formed after previous chronic or viral diseases. The degree of development of the pathological process depends on the complexity of the trauma of the nervous system.
A neurogenic bladder can be formed due to such etiological factors:
- with injuries of the spinal cord, brain, after severe operations
- neoplastic diseases of the nervous system
- compression of nerve endings on the spine during surgical intervention
- as a consequence of a stroke;
- Complication after encephalitis.
Neurogenic bladder develops due to the following reasons:
- Congenital CNS defects
- the effects of birth trauma
- congenital defects of the genitourinary system
- spine trauma.
Neurogenic bladder syndrome in children can also be formed as a result of stress, a strong emotional shock (fright).
In some cases, dysfunction of the genitourinary system can be the result of chronic cystitis or various neurological diseases.
There are two types of neurogenic bladder: hypoactive and hyperactive. The clinical picture is somewhat different, as is the nature of the development of pathology.
With a hyperactive bladder, the symptoms can be as follows:
- sudden urge to urinate (especially at night)
- complete absence or insufficient volume of fluid in the bladder;
- Difficulty emptying;
- unstable blood pressure;
- increased sweating at night;
- urinary incontinence
In more complex clinical cases, symptoms may be almost completely absent. In this case, the patient may complain of a complete delay in urine and pain in the abdomen.
The hypoactive type of a neurogenic bladder is characterized by the following symptoms:
- there are practically no contractions of the bladder;
- it is not possible to empty completely, even with a crowded bubble
- There are no signs of intravesical pressure
- straining during the exercise;
- feeling full of the bubble, even after emptying.
With such symptoms, uncontrolled urine excretion is almost always observed in small amounts.
It should be noted that such a clinical picture can lead to the development of other ailments in the genitourinary system. There is also a dystrophic change in the bladder itself.
With dysfunction of the bladder in the ureter, stones can form, which also leads to complications with urination. This, in turn, leads to the fact that the fluid enters the ureter and kidney cavity, which is the reason for the development of the inflammatory process and other diseases.
Especially dangerous is the neurogenic bladder for the baby. At an early age, the child develops the genitourinary system and if the treatment is not started in time, it can lead to serious disruptions in the kidney and genitourinary system as a whole. One should not lose sight of the psychological factor. Involuntary excretion of urine in a child can lead to the development of the complex in adulthood.
If you have the above symptoms, you should immediately contact a urologist. If such a clinical picture is observed in a child, then initially it is necessary to consult a therapist or pediatrician.
Diagnosis with a suspected neurogenic bladder begins with an examination of the patient, finding out a personal and family history. Also, the doctor must know the history of the disease. After personal examination and clarification of symptoms, instrumental and laboratory diagnostics are performed.
The standard program for laboratory diagnostics includes the following:
- blood sampling for general and biochemical research
- urine sampling for general research
- delivery of urine for examination for infections
- urine analysis for Zimnitskiy and Nechiporenko
As for instrumental diagnostics, this includes the following:
- ultrasound of the kidneys and genitourinary system
- X-ray of the urinary tract;
If such diagnostic measures did not give an exact answer, then additional examinations are carried out in the region of the brain and spinal cord. In the event that dysfunction of the bladder is observed in the child, it may be necessary to have additional advice from a psychologist. This method of differential diagnosis is needed in order to exclude dysfunction due to nervous shock in the child.
If as a result of the diagnosis it is not possible to establish the exact cause of the development of such pathological process, then the idiopathic form of the neurogenic bladder is diagnosed.
Treatment of a neurogenic bladder requires only an integrated approach. In most cases, the urologist co-operates with a neurologist and even a psychologist.
The method of therapy and treatment program depends on the degree of development of the disease, the cause of progression of the pathological process and the individual characteristics of the patient.
Neurogenic bladder can be treated in three ways:
- by a non-pharmacological method.
Medication therapy involves taking drugs of this spectrum:
- Tricyclic antidepressants
- adrenoblockers of the alpha subgroup
- calcium antagonists.
Only the specialized medical specialist prescribes the dosage and the frequency of admission. Self-medication with the above-described drugs can lead to complications.
In addition, additional injections inside the bladder — the introduction of capsaicin and resinfetaxin are used.
Non-drug treatment includes such activities:
- LFK courses
- procedures for the therapist
- adherence to proper nutrition and full sleep.
Separately, we should highlight the physiotherapy procedures. The doctor can prescribe the following to the patient:
- thermal applications
- laser therapy;
- electrical stimulation
It is much more difficult to treat hypoactive neurogenic bladder. It is due to the fact that this type of disease leads to the development of infections in the ureter and can affect the kidneys.
First of all, with the help of special medicines and physiotherapy procedures, a complete devastation of the bladder is carried out. If such a therapy can not achieve a positive result, catheterization is performed. In passing, the patient necessarily takes antibacterial drugs.
Operable treatment includes the following procedures:
- a section is made in the region of the bladder neck, for complete evacuation
- The surgical method increases the capacity
- Cystostomic drainage is established.
The type of treatment depends on the cause of the pathological process. Self-medication or use of folk remedies if and will improve the condition, then only for a while. The problem at the root of this does not solve.
If the disease does not have an innate etiology or is not a consequence of any trauma, a serious operation, then the risk of its development can be minimized. It is necessary to apply such recommendations of urologists:
- food should be full and timely;
- Do not abuse spicy and fatty foods;
- Smoking and excessive drinking should be excluded
- all chronic and infectious diseases must be treated to the end and in a timely manner
- do not allow hypothermia, sweating of feet
- with the first symptoms you need to contact a competent specialist, rather than self-medicate.
Compliance with such rules will help to avoid ailments in the genitourinary and reproductive system.