Do you also have difficulty urinating properly? Let's learn about Non-Neurogenic Voiding Dysfunction!

Do you sometimes feel like you're having trouble urinating ? Or do you feel like your bladder hasn't completely emptied after you've finished urinating ? Maybe you're even leaking urine unexpectedly. This is not just a problem for you, but for many people. Today, we're going to talk about urinary incontinence that's not caused by any neurological problems . Medically, we call this ``Non-Neurogenic Voiding Dysfunction''.

What is Non-Neurogenic Voiding Dysfunction?

Simply put, this is a condition where you are unable to completely empty your bladder. The word "non-neurogenic" here means that the condition is not caused by any problems with your nervous system, that is, your brain, spinal cord, or nerves. "Voiding dysfunction" means that the process of urinating does not happen properly.

This condition can occur in anyone. Most often, this can be due to weak bladder muscles, a blockage somewhere in the urinary system, or bad habits that we have been accustomed to for a long time. However, this condition is more common in young children who have become toilet trained between the ages of 4 and 6 and in women over the age of 40. Imagine, about one in five children between the ages of 4 and 6 have to urinate during the day because of this `(Non-neurogenic voiding dysfunction)`. Also, more than 6% of women over the age of 40 have this condition.

What are the symptoms of this condition? (Symptoms of Non-Neurogenic Voiding Dysfunction)

See if you have any of these characteristics:

• Is it difficult to start urinating ? Or do you have to strain when you urinate ?
• Is the urinary tract very narrow? Or does the urinary tract start, stop for a while, and then start again?
• Should you tighten your abdominal muscles when urinating ? Or should you hold your lower abdomen with both hands?
• Do you feel like your bladder hasn't emptied even after you've finished urinating ?
• Are you constipated ? (This is also often related)
• Are you urinating more than usual (frequent urination) or less?
• Do you accidentally leak some urine (urinary incontinence)?
• Do you suddenly feel the urgent need to urinate (urge incontinence)?
• Urinating more than once at night while sleepingDo you have to get up to do it (nocturia)?

Special characteristics that young children may have:

If young children have this condition, they may show things like:

• Wetting your clothes during the day (even after toilet training).
• There are various things that can cause urinary retention. For example:
• My legs are crossed.
• Squatting while sitting.
• They are holding their legs together, either with their hands or with their heels.

If you see your child doing these things, you should be a little concerned.

What causes this? (Causes of Non-Neurogenic Voiding Dysfunction)

There are several main reasons for this situation:

• Weakness of the bladder muscles.
• There is a blockage somewhere in your urinary system.
• Overactive bladder (overactive bladder).
• The bladder is not functioning properly, meaning that there is no feeling of needing to urinate (an ``underactive bladder'').
• Constipation (this is a very important reason).
• Urinary Tract Infections (UTIs).
• Even though you need to urinate , you ignore it and wait until your bladder is full before going to urinate later.
• In men, it is an enlarged prostate gland (Benign Prostatic Hyperplasia - BPH).
• Prostate cancer.

In young children, this can also be caused by a condition called "dysfunctional elimination syndrome," which is when the muscles and nerves in the bladder don't work together properly.

What are the possible complications of this condition?

When your bladder doesn't empty completely, bacteria in the remaining urine can cause infections. For example, urinary tract infections (UTIs). You're also more likely to develop kidney stones or bladder stones. Sometimes, if this problem gets worse, it can even cause kidney damage.

The most important thing is that having some kind of problem with urination can also affect you mentally. Many people feel embarrassed and anxious because they cannot control their urine . You may also think, "Am I a burden to others?" If you have to stop your daily activities with these symptoms all the time. If you stay away from society because of this, you may also face serious conditions such as anxiety and depression.

How do doctors diagnose non-neurogenic voiding dysfunction?

A doctor can diagnose non-neurogenic voiding dysfunction by asking about your medical history and doing a physical exam. He or she may also do a pelvic exam for women or a digital rectal exam for men.

In addition, your doctor may ask you to keep a "bladder diary." In it, you will write down:

• How much water do you drink per day?
• What time do you urinate ?
• How much urine do you pass at a time?
• When and how does urine leak unintentionally?

With this information, the doctor may also perform several other tests to confirm the diagnosis.

What tests are performed?

The doctor may do one or more of these tests:

• Prostate-specific antigen (PSA) test: This is a blood test. It looks for elevated PSA levels. If PSA levels are high, there may be a problem with the prostate gland.
• Urinalysis: This can help determine if you have a urinary tract infection (UTI).
• Ultrasound scan: This checks how much urine is left in your bladder after you urinate . It can also check if the condition has affected your kidneys.
• Urodynamic testing: These tests measure how much urine your bladder can hold and how well the muscles in your bladder, urethra, and pelvic floor are working together.
• Cystoscopy: In this test, the doctor inserts a long, thin instrument (with a camera attached) through your urethra to check for problems in your urethra and bladder.

For younger children, these tests are often less invasive. The doctor may ask you to keep a urine diary, and may only recommend a blood test, a urinalysis, an ultrasound, and some urodynamic tests.

How is this treated? (How is it treated?)

Treatment for this condition (Non-neurogenic voiding dysfunction) varies depending on the cause. Treatment may include:

1. Bladder training

You can train your bladder muscles to hold urine in for longer. This means that you need to go to the toilet at regular times throughout the day, even if you don't feel like you need to . This can help stop your bladder from overflowing. A physical therapist who specializes in pelvic floor problems can help you with this.

2. Pelvic floor muscle exercises (Pelvic floor therapy)

A specially trained physical therapist can teach you how to relax your pelvic floor muscles so that you can urinate more easily. They may also place "biofeedback sensors" in your vagina or rectum to make sure you are exercising the right muscles.

They will also teach you Kegel exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles help prevent urinary incontinence and urge incontinence.

3. Medications

There are medications that can help improve urinary problems. Examples:

• Alpha-blockers, for example tamsulosin (Flomax®).
• Urinary antispasmodics, such as oxybutynin (Ditropan®) and tolterodine (Detrol®).

4. Botulinum toxin

Your doctor may inject botulinum toxin (Botox®) into your bladder. This relaxes the bladder muscles and reduces urge incontinence.

5. Percutaneous tibial nerve stimulation (PTNS)

Sometimes, you need to give your nerves a little "boost" to stimulate your bladder muscles. In PTNS, your doctor places an electrode near your tibial nerve in your ankle. Then, they send very gentle electrical signals to the electrode. This stimulates the tibial nerve, which then travels to the sacral nerves in your pelvis. This stops the abnormal signals from the sacral nerves to the urinary sphincter, bladder, and pelvic floor muscles, helping you regain bladder control.

6. Sacral nerve stimulation

In this procedure, your doctor will surgically place electrodes under the skin just above your buttocks. These electrodes send gentle electrical signals to the sacral nerve via a thin wire (probe) that goes under the skin. These signals stimulate the muscles in your bladder to contract.

7. Self-catheterization

You can insert a urinary catheter into your bladder at regular intervals and collect your urine in a bag. Your doctor will show you how to do this (self-catheterization).

8. Surgery

If other treatments don't work, your doctor may recommend bladder augmentation surgery (cystoplasty). This surgery makes your bladder bigger so it can hold more urine .I can handle a lot.

What are the initial treatments for non-neurogenic overactive bladder?

The following are usually the first-line treatments for this condition:

• Reducing foods and drinks that are harmful to the bladder (tea, coffee, alcohol, spicy or acidic foods).
• Bladder training.

If these behavioral changes don't help, doctors may prescribe medications such as these, depending on the type of non-neurogenic voiding dysfunction:

• Anticholinergics
• Alpha-blockers
• Beta 3 receptor agonists

How is this condition treated in young children?

Alpha-blockers and anticholinergic medications can help treat overactive bladder in young children. Some children can also be taught to do pelvic floor exercises.

The doctor may also recommend bladder training. For example, encouraging the child to go to the toilet at set times and teaching them proper posture on the toilet.

How soon will I feel better after treatment?

It varies depending on the treatment. Bladder training and pelvic floor exercises can start to work in a few weeks or months. Nerve stimulation usually starts to work in a few weeks. Medications should start to work in a few days or weeks. Your doctor will give you a good idea of ​​this.

When should I see a doctor?

Talk to a doctor as soon as you first start to notice these problems with going to the toilet:

• Inability to urinate for a long time.
• Changes in your urine : For example, a strong odor, a dark color, or blood in the urine (hematuria).
• Pain when urinating (dysuria).
• Persistent symptoms of constipation.
• Signs of infection: fever, chills, headache.

When you see the doctor, you can also ask these questions:

• How do you know I have `(Non-neurogenic voiding dysfunction)`?
• What is the reason for my condition?
• What treatment do you recommend for me?
• What are the side effects of that treatment?
• How long will it take to see results from that treatment?
• What lifestyle changes do you recommend to reduce my symptoms?
• What complications should I watch out for?
• Should I see a urologist?

Can this be prevented?

You can help prevent this condition (Non-neurogenic voiding dysfunction) by making changes to your lifestyle and diet. These may include:

• Reducing foods and drinks that are harmful to the bladder: Caffeinated beverages (coffee, tea), citrus fruits (like oranges, limes), spicy foods, and alcohol can all stimulate the bladder and cause urination problems.
• Eating more fiber-rich foods: Constipation can cause or worsen this condition. You can get fiber by eating more beans, fruits, vegetables, and whole grains (whole-grain bread, oats, quinoa, brown rice, and whole-grain pasta). You can also take laxatives (` laxatives ') for constipation. However, you should talk to your doctor before taking laxatives or giving them to a child.
• Maintaining a healthy weight for you: If your body mass index (BMI) is over 25 (being overweight), it can put pressure on your bladder and cause urine leakage.
• Quitting smoking: Nicotine, the main ingredient in tobacco, can stimulate the muscles in the bladder. Smokers are also more likely to have a chronic cough, which can put pressure on the bladder.

What can I expect if I have non-neurogenic voiding dysfunction?

The outlook for people with this condition is good. With treatment, most people can control their bladder. Surgery to enlarge the bladder (cystoplasty) is rarely necessary.

What is the difference between Non-neurogenic and Neurogenic Voiding Dysfunction?

Neurogenic voiding dysfunction (also known as neurogenic bladder) is a condition that affects your nervous system. This means that you can't control your bladder because of a problem with your brain, nerves, or spinal cord.

However, the ``Non-neurogenic voiding dysfunction'' we talked about today is a condition that occurs without any involvement of the nervous system.

The most important thing to remember: Non-Neurogenic voiding dysfunction (NNOVD) is a life-threatening condition that can affect both children and adults. It can be embarrassing and uncomfortable. It can also cause you to feel like you're not going to pee when you need to. However, you don't want to let this condition affect your quality of life. If you or a loved one are experiencing these symptoms, talk to a doctor. They can help you find the cause and treat it.

Summary (Take-Home Message)

Okay, so now you have a good understanding of what we talked about today, ``Non-Neurogenic Voiding Dysfunction''. This is nothing more than a malfunction of the nervous system.This is the most important thing. Weakening of the bladder muscles, obstructions in the urinary system, bad habits, and constipation can cause this.

• Symptoms: Difficulty urinating , urinary incontinence, incomplete bladder emptying, involuntary urination , daytime urination in children, etc.
• Diagnosis: Through medical tests, urine diary, ultrasound, and urodynamic testing.
• Treatment: Lifestyle changes, bladder training, pelvic floor exercises, medications, and some specific therapies.
• Important: If you have symptoms, don't be shy and seek medical advice. Starting treatment early can prevent complications.

If you have any further questions about this, don't hesitate to ask a doctor. Stay healthy!

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