Neurogenic Bladder

The bladder (urine bag) stores the urine at low pressure, and when it reaches sufficient filling, it is discharged in an optional controlled manner.

The loss of bladder functions due to damage in any part of the nervous system caused congenitally or by trauma, infection, tumour, etc. is called neurogenic bladder.

Symptoms

It gives symptoms according to the location and level of the lesion in the nervous system. The most common findings are as follows:

Urinary Incontinence: Excessive decrease in bladder capacity, involuntary contractions of the bladder muscle or insufficiency of the urine retention mechanism (sphincter) may be the cause of this situation.

Difficulty in urinating or inability to urinate: The reason may be the inability of the bladder muscle to contract (paralysis) due to nerve damage or the inability of the urinary retention mechanism (sphincter) to relax during urination.

Frequent Urination: Involuntary contractions of the bladder muscle, decrease in bladder capacity or loss of the bladder’s ability to expand may cause this situation.

Renal Stone Formation, Urinary Tract Infections and Renal Failure: It may develop depending on the severity of the disorders in bladder filling and excretory functions.

Treatment

Medication

  • Antimuscarinic Drugs: They are used to prevent involuntary contractions in the bladder and increase bladder capacity for the patients who have problems in the filling phase of the bladder.
  • Antibiotic Prophylaxis: It is used to protect the kidneys especially for the patients with vesicoureteral reflux and for the patients with frequent symptomatic infections.
  • Alpha Blocker Drugs: If the sphincter (urinary retention mechanism) structure that needs to relax while the bladder is contracting works incongruently and remains strained, these drugs that open the bladder neck can be added to the treatment.

Intrabladder Botox Application

In this procedure, which has an activity of approximately 6-12 months, it is aimed to reduce the involuntary bladder contractions of the patients and to increase the bladder capacity, thus improving the complaints such as frequent urination and urinary incontinence.

In this procedure, which we often apply under local anaesthesia and in office conditions, botox injection is applied to 20-30 points of the bladder with the help of a special needle.

Neuromodulation (Nerve Stimulation)

It is a treatment that uses electrical current to stimulate the sacral nerves that control the bladder. There are two types of nerve stimulation:

Tibial Nerve Stimulation: A needle for electrical current is placed near the ankle. The needle passes through the skin and the tibial nerve extending from the inside of the ankle to the sacral nerves along the leg is stimulated.

Sacral Neuromodulation (Bladder Pacemaker): In this procedure, electrodes placed in the sacrum stimulate the nerves that provide the functions of the bladder with the help of a battery and ensure that the patient’s complaints about urination are eliminated.

Bladder Augmentation Surgery: It is applied to increase the bladder volume and capacity by using the intestine when other treatment methods are unsuccessful for the patients with reduced bladder capacity or impaired dilation function.

Clean Intermittent Catheterization (CAC): It is the process of emptying the bladder with disposable catheters that become self-lubricating when submerged in water in cases where the bladder loses its contractile function (excretory disorder). The number of times a day catheterization will be done is decided according to the bladder capacity.

NOTE: The page content is for informational purposes only, please consult your doctor for diagnosis and treatment.