Neurogenic Bladder 神經性膀胱
Neurogenic Bladder 神經性膀胱
The neurogenic system that controls bladder functions includes central and peripheral nervous systems. Therefore when a part of the nervous system is damaged due to stroke, Parkinson's Disease, Multiple Sclerosis, diabetes, spinal bulging, spinal injury or surgery, pelvic injury or surgery, the bladder functions could be influenced.
Moreover, bad urinating habits, organ aging, inflammation, or anxiety could cause nerve functions to deteriorate and lead to neurogenic bladder.
There are three types of neurogenic bladder, including upper motor neuron, lower motor neuron, and mixed. The representation of upper motor neuron damage is the loss of control of bladder contraction, causing bladder to contract involuntarily; as a result, bladder cannot hold and store urine. The symptoms include frequent urination, urgency, and urgent incontinence.
The representation of lower motor neuron damage is the failure to deliver the message of a full bladder to the brain, causing bladder to hold too much urine and fail to empty the bladder. Therefore, symptoms, such as dysuria, frequent urination, urgency, nocturia, inflammation, infection, and urine incontinence.
The major complications for neurogenic bladder are urinary retention, infection, and vesical thickening which leads to vesicoureteral reflux and causes hydronephrosis, or even kidney failure. Bed-ridden patients often suffer from urinary tract stones due to urinary retention, infection, and the delamination of minerals in bones.
Treatment varies depending on the type of neurogenic bladder. Urodynamics test is conducted to identify “overactive bladder” or “contraction disorder” before treatment. Common treatment is medication to reduce the involuntary contraction of detrusor muscle to relax the sphincter outside the urinary tract. Patients with exceeding urine should receive intermittent catheterization treatment to periodically empty the bladder to reduce infections and other complications.
- No smoking and drinking
- Drink 2,000~2,500 cc of water daily
- Take medicine as directed
- Good personal hygiene
- Periodically follow-up outpatient visit
- Use intermittent catheterization as directed
- Wipe from front to back after urinating
- Eat fruits rich in vitamin C, such oranges and grapefruit
Symptoms that Require Doctor's Attention
- Burning sensation when urinating
- Soreness over lower back
- Cloudy urine