Is bladder control lost due to a problem with the nervous system? Let's talk about (Neurogenic Bladder)

Normally, we feel the urge to urinate, and we control it and wait until we go to the bathroom. All of this happens through an amazing coordination between our brain, spinal cord, nerves, and bladder, which work like a computer system. But imagine what would happen if we lost bladder control due to a problem with the nervous system that carries these messages. That's what we medically call a 'Neurogenic Bladder'.

Simply put, what is Neurogenic Bladder?

The nervous system sends messages, like electrical signals, throughout our bodies. This nervous system is made up of three main parts:

• Brain
• Spinal cord
• Nerves

These nerves send a signal to your brain that your bladder is full. Then, a signal from your brain sends a message back to your bladder saying, "Now is the right time to urinate." When this signal is received, the bladder muscles contract and urine is released.

In a condition called Neurogenic Bladder, this signaling system is disrupted due to a disorder in the brain, spinal cord, or nerves. This can lead to complete loss of bladder control. That is, the bladder either becomes overactive or its function is impaired.

There are two main types of Neurogenic Bladder:

Neurogenic Bladder can be divided into two main types, depending on the nature of the nerve damage that causes it. Understanding this can help you better understand your symptoms.

What are the symptoms of this condition?

The most common symptom of neurogenic bladder is the inability to control urine. However, symptoms can vary depending on the type you have.

Why is this happening? What are the reasons?

There are several factors that can cause Neurogenic Bladder. Some are congenital, while others may be caused by diseases or accidents that occur later in life.

Possible congenital causes:

• Spina bifida: This is a complication of the spinal cord that occurs at birth.
• Cerebral palsy: A condition that affects brain development.
• Caudal regression syndrome: Impaired growth of the lower part of the spine.

Possible causes of later onset:

• Central nervous system tumors: Cancers or other tumors that develop in the brain or spinal cord.
• Multiple sclerosis (MS): A disease that damages the nerve sheaths.
• Parkinson's disease: A condition that affects the nerve cells in the brain.
• Stroke: Interruption of blood supply to the brain.
• Spinal cord injuries: Due to falls, car accidents, etc.
• Diabetes Mellitus: Uncontrolled diabetes over a long period of time can cause nerve damage.

Possible side effects (complications)

If neurogenic bladder is not treated properly, it is more likely to cause other health problems.

• Kidney damage: The pressure in the bladder increases due to urine retention, and that pressure can affect the kidneys.
• Frequent urinary tract infections (UTIs): Not emptying the bladder completely creates a good environment for bacteria to grow.
• Urinary stones: Stones can form in the bladder or kidneys.
• Vesicoureteral reflux: This is a dangerous condition in which urine flows backward from the bladder to the kidneys.

In addition to these physical problems, there can be a significant psychological impact . The fear of leaking urine can make you feel afraid to socialize or go on trips. This can lead to feelings of anxiety, depression, and loneliness . If you are experiencing these feelings, don't be shy about talking to your doctor about it.

How does a doctor diagnose this disease?

When you go to see a doctor, he or she will listen carefully to your symptoms. Then, they will examine you. If a neurogenic bladder condition is suspected, they will recommend some special tests related to the nervous system and bladder.

• Cystoscopy: Examination of the inside of the urethra and bladder using a thin, tube-like camera.
• Imaging tests: Tests such as CT scans, MRI scans, and ultrasounds.
• Urodynamic testing: This is a somewhat specialized test. It measures how much urine your bladder can hold, the pressure inside the bladder, the speed of urine flow, and how well the bladder empties.

After these tests, you may be referred to a doctor who specializes in the bladder and urinary system, a urologist .

What are the treatments for this?

The treatment plan is determined by the cause of your condition and the nature of your symptoms.

1. Lifestyle changes

First, the doctor tries to control this with simple things.

• Avoid foods and drinks that irritate the bladder (coffee, alcohol, carbonated drinks).
• Controlling Constipation: Constipation can also put pressure on the bladder.
• Bladder training: You are asked to keep a diary of the times you urinate, the amount you urinate, and any involuntary urination. This will help you learn to urinate at the right time.
• Kegel exercises: These exercises strengthen the pelvic floor muscles and can improve urinary control.

2. Medications

There are various medications that can relax the bladder muscles or stimulate contractions. For example, your doctor may prescribe medications like Oxybutynin, Tolterodine, and Mirabegron.

3. Catheterization

This method is very important if the bladder is not emptying properly.

• Self-catheterization: You will be taught how to completely empty your bladder using a clean, small tube (catheter) several times a day. This may seem difficult at first, but it will become much easier once you get used to it.
• Continuous catheterization: In some cases, a continuous catheter may be needed.

4. Other treatments and surgeries

If other treatments are not successful, your doctor may consider the following:

• Botox injections: Botox is injected into the bladder muscles to stop them from contracting excessively.
• Surgery: Surgery to increase the capacity of the bladder (augmentation cystoplasty) or surgery to change the path of urine flow (urinary diversion) may be required in very rare cases.

Your doctor will discuss with you and decide which treatment is best for you.

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