July 23rd, 2015
The activities and functions of human urinary system are very tightly regulated by the close-knit circuitry of central nervous system. For example, as soon as the urine accumulates in the bladder, a message or reflex is initiated from the walls of the urinary bladder that travels to the brain in order to serve following functions:
But it is imperative to mention that there are some pathological instances when this signal regulation does not work effectively and the message to urinate is not transmitted to the brain in time. This condition of poor neural regulation is referred to as Neurogenic Bladder. In simple words, neurogenic bladder refers to the loss of voluntary control over the bladder due to a transient or permanent defect in the neural/ nervous regulation.
Most cases of neurogenic bladder are reported in elderly. According to a new study reported in the Neuroepidemiology journal (1), investigators suggested that the mean age of occurrence of neurogenic bladder is 62.5 years. Additionally, at an average, a case of neurogenic bladder leads to approximately 16 office visits and 0.5 emergency center visits; suggesting a high economic cost.
Fortunately, in most cases, this condition can be managed with conservative and/or surgical treatments to restore normal urinary activities.
The presentation of neurogenic bladder is classic for an inability to voluntarily control the urination. The resultant effect is; too much or too less urination that may lead to deleterious complications. These symptoms include:
You must consult your physician as soon as you face these symptoms.
Neurogenic bladder is the result of a miscommunication or disconnect between neuronal circuitry and bladder receptors. In simple words, nerves that are responsible for conducting or transmitting the information between brain and urinary bladder are usually damaged in the setting of neurogenic bladder. Additionally, isolated brain disorders or spinal defects that are also implicated as a cause of neurogenic bladder include:
The bladder muscles can also be damaged due to the following reasons:
The diagnosis of neurogenic bladder can be made via tests (such as strength of bladder muscles) or nerve function tests (for nervous system). Correct diagnosis can help your physician in prescribing appropriate treatment options.
The long term effects of neurogenic bladder are devastating on the human body. For example, some notable complications include; loss of control on the urination, loss of urge to void or empty-out the bladder and negative changes in the control over the bladder. It also results in the stretching of bladder walls or loss of stretch reflex.
Some notable complications of neurogenic bladder include:
There are several tests and investigations that can be used to identify this condition. For example:
Physical examination and detailed history helps in making the preliminary diagnosis and allowing your physician to advise appropriate tests to confirm the etiology and diagnosis. Most vital investigations that are commonly used for the final diagnosis of neurogenic bladder are:
The results clearly determine that helps the physician to diagnose whether the patient has neurogenic bladder or not.
The treatment of neurogenic bladder is dependent on the exact diagnosis and comorbid medical conditions. Most frequently used treatment modalities include:
References:
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