Neurogenic bladder - Causes, Symptoms and Treatment .MF .
Neurogenic bladder - a group of diseases, which is based on a violation of section of the nervous system responsible for the innervation of the bladder and urinary tract.The essence of the violation consists in the fact that the bladder is controlled by only the spinal cord, that is the process of urination completely loses touch with human consciousness.The clinical course stands hypotonic and hypertonic form of neurogenic bladder.
Causes of pathology
etiological factors of neurogenic bladder can be organic or functional.Accordingly, they are divided into permanent and temporary.
As for functional disorders of innervation of the bladder, it can develop as a result of stress or a strong emotional shock.At the same time, most often, neurogenic bladder becomes not the result of one-time and permanent chronic emotional disorders.
As for the organic causes, then they tend to include brain and spinal cord injury.In this case, the connection between the cortical centers of urinary tract and the bladder i
also cause the development of neurogenic bladder sphincter can be a pathology unit, which develops against the background of inflammatory and destructive disease of the bladder or urethra.In addition, the disorder may cause the sphincter also be an injury is not only nerve trunks and of the bladder.
Some sources of medical literature describes another form of the disease - congenital neurogenic bladder.The reason for its development are defects of the spinal cord or newborn birth trauma.
innervation of the bladder reflex arc
Symptoms of neurogenic bladder
As already mentioned, neurogenic bladder has two variants of flow - a hypertonic and hypotonic, which are characterized by very different symptoms.When hypertonic bladder first appear frequent urination that end the release of a small amount of fluid, and sometimes at all, the inability to urinate with a great desire.Also, there is hypertonicity body, which is characterized by unpleasant sensations in the lower abdomen painful.In patients having persistent nocturnal desires, which in most cases also do not end successfully.
When hypotonic form of neurogenic bladder marked a completely different picture, which is characterized by a strong body and overflow complete inability to urinate.In such a situation it is necessary to resort to medical methods for evacuation of fluid from the bladder.
If any of the forms of neurogenic bladder will soon start to develop mental disorders.These patients, due to a bad smell, can not adapt in their familiar environment that causes severe emotional turmoil, which only complicate the situation.There are even cases where urinary problems became the reason for suicide attempts among young people.
If you experience any of these symptoms should immediately seek help from a urologist who or prescribe treatment alone or redirect the patient to a neurologist.
diagnosis of neurogenic bladder
In recognition of the causes of the disease plays an important role not only a doctor but also the patient.From the latter requires active management of the diary, which is celebrated as the frequency of urination per day and the amount of urine.This is necessary not only for the diagnosis of the disease, but also to identify the shape of the latter.
In the case where the disease affects young children, to help them to keep a diary parents, who also recorded the frequency of urination and the amount of the latter.
When the diagnosis of neurogenic bladder has been made, recourse to the second stage of diagnosis - clarify the causes of the disease.To do this, we conducted a full range of laboratory and instrumental studies: complete blood count, urinalysis, urine analysis Zimnitsky, Nechiporenko, excretory urography and renal ultrasound mandatory.
Neurogenic bladder with contrast radiography
When disease sfinktenogo apparatus can be excluded, have resorted to the study of the nervous system.After the MRI and CT of the brain, as well as neurosonography often unable to accurately determine the cause of the disease.
Also, there are cases when after the full range of clinical and laboratory research can not determine the cause of the pathology.In such a situation, speak of idiopathic neurogenic bladder.
Treatment of neurogenic bladder
treatment of this disease, according to its root cause, produced in urology or neurology department.If the cause of the disease is any neurological functional nature of the disorder, the patient in need of therapy sessions, which take place in the therapist's office.
If a neurogenic bladder caused swelling or brain or spinal cord injury, the patient needs a specialized neurosurgical care.Its volume can be to remove the tumor or hematoma, which arose due to traumatic vascular injury, feeding the brain tissue.
In inflammatory or destructive diseases of the urinary system help provide urologists.It applies specialized treatment of a disease of the genitourinary system.
When hypotonic neurogenic bladder form, regardless of the reasons for the latter, performed drug evacuation of urine from the bladder.It can be accomplished by setting a urethral catheter or if you can not perform the latter, the imposition epitsistostomy.It implies a creation of an artificial opening in the abdominal wall above the pubis, for the production of a special conductor, through which the flow of urine occurs.It should be noted that this procedure can be permanent or temporary, if after treatment begins regression of symptoms.
Feeding habits and lifestyle with neurogenic bladder
often cause neurogenic bladder becomes some kind of inflammatory pathology of the genitourinary system.In the course of her treatment to include dietary food.Most often, it is the seventh table on Pevzner, which eliminates from the diet salty, sour, smoked, spicy and other extractives, which may exacerbate the inflammatory process or disrupt function of the kidneys.
As for the lifestyle, the more often it should be recumbency.That this requires a treatment plan in traumatic injury of the brain or spinal cord.If the injury is not as substantial or cause neurogenic bladder served as something else, then at the time of treatment the patient is best to avoid the usual for him and the team to undergo treatment in a hospital.This will help maintain the stability of nervous at the same level and will lead to a speedy recovery.
rehabilitation after illness
most often in need of rehabilitation patients who have neuropathic bladder was caused by some other disease, more often, an inflammatory nature.They need to avoid hypothermia and to adhere to the normal health of the external genitalia.Some diseases, such as kidney stones, which can also become a cause of neurogenic bladder, gives a very good effect in the spa treatment.They are best mineral spas, field type and Morshyn.
When neurogenic bladder caused by psychological disorders, requires long-term continuous rehabilitation psychologist.It is psychotherapy, which not only strengthens the nervous system, but also to prevent the recurrence of the disease.
Treatment folk remedies
worth noting that neurogenic bladder - this is one of the few diseases that lend themselves to popular treatments.However, to date, these methods have been firmly rooted in traditional medicine.Everyone knows "pumping" is now successfully used by psychologists, but in a somewhat modified form.We mean psychotherapy, in which folk healers are under the guise of the procedure, during which the usual chicken eggs disease as it is pumped out of the body.
As for the popular herbs and infusions, the effect is expected except that only from decoctions of plants that have a calming effect.In the example, chamomile broth well calms the nervous system and has a positive effect in the treatment of neurogenic bladder.
complications of neurogenic bladder
Complications of the disease can be very dangerous.The first thing to say about psychological disorders that may be caused by neurogenic bladder.As already mentioned, in medicine reported several cases where neurogenic bladder resulted in a suicide attempt.
most common complication of this disease is considered to be urinary incontinence, because it officially does not belong to the symptoms of neurogenic bladder.Most often it is observed in hypertensive form of the disease.
As hypotonic variant, it is accompanied by stagnation of urine in the bladder, which eventually leads to the occurrence of reflux of urine into the ureters.This is followed by renal failure and uremia, ie septicemia urinary toxins.
Another outcome of the full bladder - a rupture of its wall.The consequence of this complication is peritonitis, which also leads to infection of the blood, but a slightly different nature.In both cases, these complications of neurogenic bladder can be fatal, so it is important to time to see a specialist.
profilaktirovat necessary not the neurogenic bladder, and diseases that lead to it.To do this, you need to save ourselves from hypothermia and trauma pelvic and spine.First of all, this applies to people who engage in contact sports and traumatic.
If a person gives in constant stress, he should think about changing the place of work or residence.If the cause of a nervous breakdown is not in it, then we need skilled help of a psychologist.
Ed.urologist Astashin EE