Neurogenic bladder is when the bladder does not hold urine because its
nerve control is damaged. Bladder functions are coordinated by the brain,
with the commands transmitted to the bladder by means of nerves traveling
though the spinal cord. Imagine what happens if something happens to any
of these structures: the bladder and sphincter cannot do their job properly.Neurogenic
bladder causes a wide variety of symptoms. If the bladder fails to store
urine properly, you may need to use the bathroom all the time. You may
need to get up often throughout the night, or you may experience involuntary
loss of urine (or urinary incontinence).
Brain, spinal cord, or nerve injury
The brain may get hurt in multiple ways. Trauma, stroke, or diseases such
as multiple sclerosis or Parkinson’s disease will lead to problems
with normal bladder function. Depending on severity and location of the
brain damage, the urinary tract may still function normally, however without
your control. This this leads to bladder emptying at inappropriate times.
Treatment may include using a catheter.
Spinal Cord Injury
Two stretches of nerves connect the brain and bladder. One connects the
brain to a control center in the spine at about waist level and the second
nerve connects this control center to the bladder. The bladder will fail
to empty if the nerves connecting the brain and spinal center are damaged.
The muscle tone of the sphincter will still be intact, which holds urine
back, yet the bladder remains relaxed, causing the inability to pass urine.
In this phase, bladder emptying must be helped, usually with a small tube
inserted into the bladder several times a day.
Over time, without nerve input inhibiting the spinal bladder control center,
the bladder becomes spastic and overactive. Fewer triggers cause the bladder
to contract, it to become very small and may cause kidney damage.
Peripheral Nerve Damage
Nerves from the spine to the bladder are called peripheral nerves as they
are located away from the brain and spine. Injury or conditions such as
diabetes or mellitus may damage the peripheral nerves, leading to an inability
to empty the bladder. This may cause urinary retention, with can lead
to chronic urinary tract infections, or kidney failure. Therefore early
detection and treatment is necessary to keep the kidneys healthy and to
improve/maintain your quality of life.
Urinary Tract Infections
The urinary tract is the body’s system to eliminate toxins in the
urine. It originates with the kidneys which produce urine, which flows
down to the bladder in two tubes called ureters. Once in the bladder,
the fluid is stored until it is released through the tube called urethra
when we urinate.
What is a Urinary Tract Infection (UTI)?
An infection of this system most commonly only involves the bladder. Bacteria
enter it by climbing back through the urethra, and once there, multiply
in numbers. When the body tries to fight this, inflammation occurs.
What are the symptoms of an uncomplicated UTI?
Normally, bacteria only reach the urethra and the bladder. This causes
symptoms of having to go often (even at night), having to go very urgently,
and pain during urination.
Difference between men and women
In women, infections of the urinary tract can occur more frequently than
in men. This is simply because the distance between the outside and the
bladder is fairly short, only about one to two inches. This makes a UTI
a fairly common and benign condition, which is simply treated with a course
of antibiotics. In men, however, the distance to the bladder is longer
and infections occur less often.
More serious infections
When treating these infections, it must be determined whether the infection
reaches the kidneys. If so, a minor bladder infection becomes a potentially
life-threatening kidney infection, or pyelonephritis. The latter is more
severe because it involves a solid organ meaning that there is the possibility
of the infection spreading into the blood and on to the entire body.
Any fever, chills, lower back pain or fatigue which occurs with urinary
tract symptoms may point to this serious condition and needs to be addressed
right away. A urine culture is completed and a CT may be done to determine
how serious the infection is.
Causes for UTIs: Persistent or Recurrent Infections
Most urinary tract infections are harmless, as explained above, and no
further workup looking into why infections occurred is necessary. Persistent
or recurring infection should be evaluated.
- Incomplete Bladder Emptying
- Kidney and Bladder Stones
- Neurogenic Bladder