Neurogenic bladder in women, men: treatment, symptoms
With the defeat of parts of the nervous system that are responsible for the urinary process, diagnose neurogenic bladder. Neuromuscular disease diagnosed in patients of different age groups, because the nervous system is manifested as a congenital defect or acquired over time, influenced by various factors. For the diagnosis of neuromuscular disease used methods such as ultrasound, urography, tests, radiography etc. as treatment of disease use medical therapy, traditional methods, and in more complicated cases, perform surgery. For successful therapeutic effects need for timely treatment of the patient to the doctor, when a person begins to show the first signs. How does the disease and what factors influence its development?
General information about the disease in women and men
Neurogenic disorders of urination are quite common in urological practice. In the pathology the patient is unable to produce the urinary act, which develops on a reflex level. This is prevented by lesion of the nervous system responsible for regulation of processes of allocation of urine. These disorders affect social moments in the life of the patient, because it significantly limits both physical and mental activity of the patient, and it’s harder for him to adapt to society.
According to statistics, the disease develops in men and women with equal frequency, and can lead to disturbance of sexual function, disturbances in the digestive system. At the same time with the disease, the patient may be a manifestation of myofascial syndrome, and venous congestion in the pelvic region. Also the patient is often on the background of the disease develop secondary inflammatory processes in the urinary system. Such complications include chronic cystitis, pyelonephritis, renal failure in the chronic form, due to which the patient will be disabled for the rest of my life.
Classification of neurogenic bladder dysfunction
Neurogenic dysfunction of the bladder has several classifications. Depending on the severity of the disease distinguish 3 stages: easy, medium and hard. On light stage man is hard to hold back urine when you strain, he has nocturnal enuresis. In the middle stages appear stagnation of urine and urinary act is very rare. During the severe stage a person can not hold back urine, constipation, as well as in the urinary tract the infection spreads. In practice, more focused on the classification of distributing the ailment depending on the nature of the flow into 3 types: hyporeflectivity, reflectory and hyperreflection bladder.
Hyporeflectivity bladder appears because of the bad functioning of the nervous system, manifesting itself in the sacral area. This type is peculiar to that muscles cease to contract properly, so urinating on a reflex level does not occur. Due to accumulation of large amounts of fluid, the bladder begins to increase in size, accompanied by pain. Because of this, failures occur in the functioning of the sphincter and man cannot restrain the urine. Hypoactive urinary bladder manifested without pain, but later in adults and children relax the sphincters.
Spastic or overactive bladder
The disease has a second name — spastic bladder. Hyperreflection bladder manifests itself in the failure of the nervous system in Namestovo region of the brain, with increased activity of the bladder muscles. As a result, the body fails to keep available the urine and in contact with the liquid in the bubble it is deployed. Neurogenic overactive bladder can be associated with development of cystitis, resulting in a wrinkled bladder and is sclerosis. For treatment this form is used only surgical method, as it requires expanding the size of the body.
In the presence of reflecting bladder cannot consciously produce urinary act at the first urge. While in the bladder accumulates a large amount of liquid filling the maximum amount of on. After this there is incontinence of urine and urine excreted at any time. This type of disease can lead to chronic delay of urine and if untreated will experience complications, among them kidney stone disease, cystitis, etc.
The reasons for the development of the disease
There are 2 groups of factors causing the progression of the disease: functional, organic. Functional factors include stressful situations or a strong emotional shock, while effects are due to long-term emotional bursts. In the group of organic factors include injury to the brain or spinal cord, causing degeneration of the joints.
In addition, the disease occurs on the background of pathologies of the sphincter, developing as a result of inflammatory processes and injuries of the bladder. Neuromuscular disease may be associated with congenital abnormalities of the spinal cord, including those with injuries sustained in the birth process. In young patients the neuromuscular dysfunction of the bladder develops due to disturbed physical and mental performance, spinal hernia, tumors and birth defects. Neurogenic disorders of urination in Mature patients develop because of such reasons as:
- the presence of abnormalities of the brain, among which are multiple sclerosis, impaired cerebral blood flow, and Parkinson’s syndrome;
- the development of diseases of the spinal cord, which include the schmorl’s hernia, low back pain, complications after operations on organs of the urinary system, dystrophy that affects the small vertebral joints;
- pathology affecting the receptors of the bladder;
- manifestation of HIV infection.
What are the symptoms in men and women?
Depending on the form in which the disease appears, develop different characteristics. Failures hypotonic bladder function is manifested by the fact that a person overflowing liquid body, but fails to produce the urinary act. To urine out of the bladder, the patient has to push, and in some cases, the fluid leaks out.
Hypertensive form of the bladder the urethra is marked by frequent acts, during which a small amount of liquid. The urge can be quite strong, because of which the patient is incontinent of urine. Night time enuresis is observed, which goes daily volume of liquid. Patients observed a thin and intermittent stream, and after urination there is a feeling that not all of the liquid out. The allocation of urine, the patient troubled by pain, and before that increased levels of sweating and a rise of the pressure data.
Whatever kind of disease or was diagnosed, the patient has a mental disorder. Observed the inability to adapt in the environment that appears because of the bad smells. This leads to the fact that developing emotional shaking that worsens the disease course. In medical practice there were cases when patients tried to commit suicide. In avoidance of such at the first symptoms need to seek medical help.
Possible complications and consequences
Neurogenic bladder in women and men is often accompanied by complications which are dangerous for human life. First of all, is a mental disorder that can lead to suicidal outcome of the patient. As complications stands incontinence of urine, not related to the characteristics of the disease, and is manifested in hypertension.
Hypotension bladder in women and men ends with fluid retention, so that there is reflux of urine into ureter channels. Because of this impaired functioning of the kidneys and then the blood is infected with toxins of urine. Full bladder can lead to rupture of the walls of the body and the result is diagnosed with peritonitis. In this complication of infected blood, which leads to death.
For an accurate diagnosis, first of all, make up the history of the patient, during which is determined the complaint of the person, the presence of comorbidities. Then I look at the hereditary factor to determine similar diseases in relatives. After that, the patient is administered a blood and urine tests to determine chemical and physical properties, to examine metabolic processes, infection, etc. With the help of ultrasound bladder and kidney condition of the body, its external indicators, and also examined the amount of liquid that remains after the urinary act.
Diagnostics, including MRI, provides an opportunity to assess the real state of the brain and spinal cord, to detect the presence of degeneration of the joints. When conducting cystourethroscopy examines the bladder wall. With the help of x-ray surveys detect anomalies in the structure of the bubble. Neurogenic bladder is diagnosed when conducting a comprehensive urodynamic examination, which determines the functioning of the urinary canals. For comprehensive examination of the patient should visit a neurologist or psychiatrist, because the symptoms are not only physical but also on mental levels.
Treatment of the bladder: basic methods
Drug treatment of neurogenic bladder in men and women involves taking alpha-adrenoblokatorov lowering the tone of the sphincter («Phentolamine», «Tropafen»). To increase the pressure inside the bubble used beta-blockers, including «Inderal». Using the alpha-agonists the stimulation of sphincter tone and urinary incontinence disappears (e.g., the «Ephedrine»). Drug therapy gives the result only in mild stages of the disease, and the effect of it short-term.
To select the most appropriate physiotherapy method can only be a doctor. When hyperreflection the form of use of methods of physiotherapy, which have sympathomimetic and antispasmodic effects. Patients with hyporeflectivity form prescribed myostimulating ways. To lower tension when urination, ultrasound therapy, medicinal electrophoresis antispasmodics and anticholinergics. To stimulate muscle function is prescribed electrophoresis with neostigmine and diadinamotherapy.
Conducting physical therapy
To treat neuromuscular dysfunction of the bladder by using exercises, which strengthen pelvic muscles and normalizes the tonus of the bladder. Exercises are conducted in the physical therapy office where the patient is under the supervision of experts performs correctly the elements of medical gymnastics. But physical therapy can be practiced at home and at work. Effective are Kegel exercises which are prescribed to patients. They strengthen the muscles like the urinary system and vagina.
In order to treat neurogenic bladder, used homeopathy, reinforcing effects of drugs and physical therapy. Homeopathic medicines aimed at the treatment of the early stages of the disease, but are effective in severe stages and complications. For the treatment of patients prescribed «»Petroselinum» or «Uralan».
A psychotherapeutic method
The primary medical complex is always accompanied by psychotherapy, since it is necessary to improve the psychological health of the patient. When conducting therapy sessions, people have a higher self-esteem which has been lowered due to the depression. The patient is instructed to keep a special diary in which is recorded the number of visits to the toilet.
If you are not able to cure neurological disease, conservative methods of treatment, the patient is administered an operation that effectively treats the disease. For the treatment of neuromuscular disease of any form carry out the plasticity of the tissues, the purpose of which is to increase the volume of the bladder. Also patients set zitostaticski drainage, whereby the body is emptied without obstruction.
Food and way of life of the patient
In the treatment process the patient is in the hospital so the doctors monitored his condition and had made adjustments. If a nervous disease develops on the background of injuries of the brain or spinal cord, a person is constantly in the supine position. Also patient is prescribed a special diet menu, which is excluded salty, sour, smoked and fatty foods. Prohibited the consumption of carbonated drinks, strong coffee and tea. Exclusion from the diet of junk food reinforces the main therapeutic methods and relaxes tense fate, and, therefore, patient will have full control over urination.
Treatment of folk remedies
Neurogenic bladder is not treatable with folk remedies. But in order to calm the nervous system, used special teas made from herbs. An effective remedy is chamomile decoction, reinforcing the impact of basic therapeutic techniques and calming the nerves of the patient. In addition, the broth is struggling with a possible accumulation of the infection.
Prognosis and prevention of the development of the disease
If the patient appealed to the doctor at the first sign and was assigned to the medical complex, the prognosis is favorable and the patient will be able to get rid of the disease in the coming time, it will achieve complete control over the act of urination. In cases where the disease was identified in childhood, the child’s development the symptoms disappear. In the absence of treatment, the person developing complications that can lead to death.
Preventive measures are directed not on neurogenic bladder and its causes. To avoid the development of the disease the patient should not prevent hypothermia, you also need to avoid injuries of the spine and pelvis. In particular, this applies to people involved in sports. You should also avoid stressful situations that affect health.