Is it difficult to urinate? Is the bladder not emptying completely? (Non-Neurogenic Voiding Dysfunction)

Do you sometimes feel like you still have some urine left after you pee? Or is it a little difficult to start urinating , or does it take a while? Maybe your little one, even though he's now toilet trained, still wets his clothes during the day? These are not just things that happen and are nothing to be ashamed of. This is a medically explainable condition that many people have. This is what we're talking about today.

What is this Non-Neurogenic Voiding Dysfunction?

This English name may sound a little intimidating, but it's actually quite simple. Let's break it down.

• "Non-neurogenic" means that it has nothing to do with the nervous system . That means it's not caused by any problems with your brain, spinal cord, or nerves.
• "Voiding dysfunction" refers to a weakness in the process of urinating .

Simply put, Non-Neurogenic Voiding Dysfunction is the inability to completely empty your bladder without any problems with the nervous system.

This condition can occur in anyone, but it is most common in children between the ages of 4 and 6 who are toilet trained and in women over the age of 40. However, it can also occur in men.

What are the symptoms of this condition?

These symptoms do not occur in everyone the same way. Some people may have one or two, while others may have several. Let's look at the main symptoms that are seen.

Why is this happening? What are the reasons for this?

There is no single reason for this. There may be several reasons. Sometimes, several reasons come together to cause this situation.

• Weakening of the bladder muscles: The bladder is like a bag made of muscles. When these muscles weaken, they lose the strength to push all the urine out.
• Urinary tract obstruction: If there is a blockage somewhere in the system through which urine flows, the bladder will not empty completely.
• Overactive bladder: When the bladder is even slightly full, it sends unnecessary signals to the brain saying, "I need to urinate now."
• Underactive bladder: This is the opposite. The bladder is full but does not send the signal to the brain that it needs to urinate .
• Urinary tract infections (UTIs): These symptoms can also occur due to urinary tract infections.
• Controlling the urge to urinate: If you hold on for too long when you need to urinate , thinking, "I'll go in a moment," your bladder can become overfull and your muscles can become weak.
• Benign Prostatic Hyperplasia: As men age, the prostate gland can enlarge, causing pressure on the urethra and obstruction of urination.
• Prostate cancer: This can also cause urinary tract obstruction.

If this is ignored, serious consequences may occur.

This is not a life-threatening disease, but if left untreated for a long time, it can lead to certain complications.

• Frequent urinary tract infections (UTIs): Because there is always some urine left in the bladder, bacteria can easily grow inside it and cause infections.
• Kidney or bladder stones: Mineral salts in the remaining urine are more likely to accumulate and form stones.
• Kidney damage: In severe cases, pressure in the bladder can increase, causing urine to back up into the kidneys, damaging the kidneys.

In addition to these physical problems, there can also be a significant psychological impact . Involuntary urination can make people feel embarrassed and afraid to socialize or hang out with friends. This can also lead to psychological problems such as anxiety and depression for some people.

How does a doctor find this?

When you go to see a doctor, he will follow several steps to accurately diagnose this condition.

1. Asking you for details: They will ask you a lot of questions, such as what your symptoms are, how long you've had them, how many times you urinate per day, and how much water you drink.

2. Physical examination: This may include an abdominal examination, a pelvic exam for women, and a digital rectal exam for men.

3. Asking you to keep a bladder diary: You may be asked to record things like how much water you drink, when you urinate, and the amount of urine you pass for a few days. This can give you a good idea of ​​your urination pattern.

In addition, several other tests can be done to find the exact cause.

What are the treatments for this?

The best thing is that there are effective treatments for this. Your doctor will determine the treatment based on the cause of your symptoms.

Bladder training

This is like teaching your bladder to work on time. Even if you don't feel the need to urinate, you should go to the toilet on a schedule given by your doctor (e.g. every 2 hours). This will prevent your bladder from filling up too much.

Pelvic floor therapy

This treatment can be done under the guidance of a physiotherapist. They will teach you how to properly relax the pelvic floor muscles when urinating. You can also strengthen these muscles through things like Kegel exercises and control involuntary urine leakage.

Medications

There are various types of medications that can be used to relax the muscles of the bladder, or to stop them from contracting unnecessarily. Alpha-blockers and urinary antispasmodics are two such classes of medications. These should only be taken on medical advice.

Other specific treatments

If the above treatments do not yield successful results, the doctor may suggest other treatments.

• Botulinum toxin (Botox®) injections: This injection is given to relax the muscles of the bladder.
• Nerve stimulation: Sometimes small electrical signals are sent to stimulate the nerves that control bladder function.
• Self-catheterization: A method of removing urine by inserting a clean tube (catheter) into the bladder several times a day when the bladder is unable to empty itself. A doctor or nurse will teach you how to do this.
• Surgery: This is done very rarely. If no other treatment is successful, a surgery to enlarge the bladder (cystoplasty) may be performed.

What can we do to avoid this situation?

Making some lifestyle and dietary changes can help prevent this condition from occurring and also help control symptoms.

• Reduce foods and drinks that irritate the bladder: Things like coffee, tea, alcohol, citrus fruits (oranges, tangerines), and spicy foods can stimulate the bladder. Try reducing these a little.
• Eat more fiber-rich foods: Constipation is a major cause of this condition. So, add fiber-rich foods like leafy greens, vegetables, fruits, and whole grains (beans, oats, chickpeas) to your diet.
• Maintain a healthy weight: As body weight increases, pressure in the abdominal cavity increases, putting pressure on the bladder. This can lead to unintentional urine leakage.
• Avoid smoking: Nicotine, a chemical found in tobacco, relaxes the muscles in the bladder. Also, the chronic cough that smokers have can put pressure on the bladder.