Urology >>>> What is neurogenic bladder?

What is neurogenic bladder?

The inability to reflexively fill the bladder with urine and / or remove it outside of it is called "neurogenic bladder".

Filling and emptying of the bladder is accomplished by the sphincters, which are ring-shaped muscles that expand reflexively to fill the bladder and reflexively contract to hold urine within the bladder, as well as the bladder detrusor, which is responsible for emptying the bladder. The sphincters (upper and lower) and the detrusor muscle work alternately (one is open, the other is closed).

With correct reflexes, the urge to empty the bladder begins when it is filled to a certain volume (the bladder can accumulate up to 1-2 pints of urine). If the innervation of the walls of the bladder itself (detrusor) or the lower sphincter of the bladder is disturbed, urine flow begins earlier than necessary (the bladder is 25% full). In this case, a person can feel tension in the bladder, as if it were full. The pressure inside the bladder rises and the process of urination begins. In such cases, the pathology is called an overactive bladder (hyperreflex).

There is another type of pathology, when, when the bladder is full, the detrusor does not work, and urine does not drain - the bladder overflows, the pressure on the walls of the bladder increases, and the person experiences painful sensations. This type of pathology is called a hypoactive bladder (hyporeflex).

In fact, a neurogenic bladder is a symptom of a disorder in the functions of the organs of the excretory system. Such disorders, as a rule, originate in damage to the central nervous system (spinal cord and brain) or the innervation of the urinary organs themselves.

The syndrome of a neurogenic bladder manifests itself as urinary incontinence or as an inability to empty the bladder. Treatment of a neurogenic bladder requires a preliminary study of all organs of the urinary system, as well as a study of disorders in the spine, pelvic organs, and the brain.

To restore the emptying function, laparoscopic surgery is performed to shorten the bladder neck. This makes it possible to stimulate the emptying of the bladder by external influence on it (pressing on the bladder). If the neurogenicity of the bladder is associated with the impossibility of stretching the walls of the bladder and accumulating a certain amount of urine, they resort to plastic surgery of the bladder, thus increasing its volume. Forced emptying of the bladder is also carried out using the installation of drains.