Do you also have difficulty controlling your urine? Maybe the cause is in the nervous system! (Neurogenic Bladder)

Do you sometimes feel like you can't control your bladder ? Do you suddenly feel the need to urinate, or do you feel like you can't urinate properly? This is not just something else, it could be due to some problem in your nervous system. That's what we medically call Neurogenic Bladder. Let's talk about this simply, in a way that you can understand.

Simply put, what is Neurogenic Bladder?

Think of your body as a complex electrical circuit. The brain is the master control center. Messages travel from the brain to all parts of the body via nerves. When your bladder is full, it sends a signal to the brain saying, "Okay, now the bladder is full, you need to empty it." Then, when the time is right, the brain sends a signal to the muscles in your bladder to contract, and it also sends a signal to open the passage for urine to pass through. All of this happens through the nervous system. In a condition called Neurogenic Bladder, this signaling system is disrupted due to damage to the brain, spinal cord, or nerves. It's like a miswire. As a result, the bladder doesn't get the right messages, or it gets the wrong messages. As a result, you can lose control of your bladder.

There are two main types of Neurogenic Bladder:

Depending on the way the nervous system is damaged, Neurogenic Bladder can be divided into two main types. 1. Overactive Bladder (Spastic Bladder): In this case, the bladder contracts frequently and uncontrollably. To be precise, the brain keeps sending signals to empty the bladder even when it is only slightly full. This causes the bladder to feel like it needs to urinate frequently, and the urge to urinate suddenly. 2. Underactive Bladder (Flaccid Bladder): The opposite is true. The bladder muscles do not receive the right signals to contract. Therefore, even when the bladder is full, it is difficult to empty it completely. Urine may remain in the bladder.

What are the symptoms of this condition?

Symptoms may vary depending on the type of Neurogenic Bladder you have. Let's take a look at what these symptoms are.

Why is this happening? What are the reasons?

There are many possible causes of Neurogenic Bladder. Some are congenital conditions, while others may be caused by illnesses or accidents that occur later in life.

Congenital causes

• Spina bifida: This is a condition that occurs when the spinal cord does not develop properly at birth.
• Cerebral palsy: A condition that affects brain development.
• Caudal regression syndrome:Failure of the lower spine to develop properly.

Later causes

• Spinal cord injuries: Damage to the spinal cord from an accident or fall.
• Diseases affecting the nervous system:
• Multiple sclerosis ( MS )
• Parkinson 's disease
• Stroke​
• Central nervous system tumors: Tumors that develop in the brain or spinal cord.
• Diabetes: Long-term diabetes can cause nerve damage.

Other problems (complications) that may arise due to this

If neurogenic bladder is not treated properly, other health problems can occur.

• Frequent urinary tract infections (UTIs): Urine remaining in the bladder increases the chance of bacteria growing and causing infections.
• Kidney damage: Kidney damage can occur due to increased pressure in the bladder or due to urine flowing backward into the kidneys ( vesicoureteral reflux ).
• Urinary stones: Stones can form in the bladder or urinary system.
• Psychological impact: Inability to control your urine can make you feel shy and afraid to go out in public. This can lead to feelings of anxiety and depression . Don't hesitate to talk to your doctor about these feelings.

How does a doctor find this?

When you tell your doctor about these symptoms, he or she will ask you about your medical history. Then, they will perform a physical exam. If neurogenic bladder is suspected, they may recommend several tests to determine the exact cause.

• Imaging tests: You may be asked to do an ultrasound scan, CT scan , or MRI scan to look at your kidneys and bladder.
• Cystoscopy: A thin, camera-equipped tube is passed through the urethra to examine the inside of the bladder.
• Urodynamic testing: This is a special test that measures how much urine your bladder can hold, the pressure inside the bladder, the speed of urine flow, and how well your bladder empties.

After these tests, you may be referred to a urologist.

How is it treated? Can this be cured?

The treatment plan is determined based on your symptoms, the severity of the condition, and the cause.

1. Lifestyle changes and bladder training

The doctor will tell you to try things like this first.

• Keep a bladder diary: Keep a record of how many times you urinate per day, how much you urinate, what you drink, when you need to urinate, and any times you accidentally urinate. This can help you identify a pattern and get used to urinating at the right time.
• Diet: Things like coffee, tea, alcohol, and carbonated drinks can quickly stimulate the bladder. It is advised to limit them.
• Kegel exercises: Exercises that strengthen the pelvic floor muscles.

2. Medications

There are medications that can reduce excessive bladder muscle contractions or relax the bladder. For example, medications like `oxybutynin`, `tolterodine`, `mirabegron`. These should be used only under medical advice.

3. Catheterization

This method is very important for those who cannot completely empty their bladder.

• Self-catheterization: Emptying your bladder by inserting a clean, small tube (catheter) into your urethra several times a day. Your doctor or nurse will show you how to do this.
• Continuous catheterization: The use of a catheter that can be worn continuously.

4. Other treatments

• Botox® injections: Botox can be injected into the bladder muscles to reduce their overactivity.
• Surgery: If no other treatment is successful, surgery may be considered. For example, an augmentation cystoplasty or a urinary diversion.

Your doctor will discuss with you what treatment is best for your condition. Neurogenic Bladder, urinary control, nervous system, bladder, bladder control sinhala, urinary incontinence sinhala, urinary retention sinhala