What is neurogenic bladder and urinary incontinence

Neurogenic bladder is a condition caused by abnormalities in the nervous system that can lead to impaired voluntary urination, which can cause problems such as urinary incontinence. This condition is common after spinal cord injury, stroke, multiple sclerosis and other diseases, and is mainly manifested by poor urine control, which may include frequent urination, urgency and urinary incontinence. Treatment includes medication, behavioral training and surgical intervention.

1. Causes of neurogenic bladder

-Genetic factors: Some neurological diseases, such as familial spinal cord disease, may increase the risk of neurogenic bladder.

- Environmental factors: External trauma, especially spinal cord injury caused by car accidents or work-related injuries, is a common cause. Long-term fatigue or repeated exposure to cold may aggravate symptoms.

- Physiological and pathological factors: Common neurological pathologies include:

1. Spinal cord injury: Spinal cord damage may affect the nerve innervation of the bladder and sphincter, leading to urethral pressure imbalance and urine storage dysfunction.

2. Brain diseases: such as stroke, brain tumor, brain trauma, etc. will affect the normal function of the urination center.

3. Chronic neurological diseases: such as multiple sclerosis, which may cause overactive bladder or weak urination.

4. Diabetes: Long-term uncontrolled high blood sugar can easily damage the nervous system and can also lead to neurogenic bladder.

2. Types of urinary incontinence caused by neurogenic bladder

Urinary incontinence caused by neurogenic bladder mainly includes the following types:

-Reflex incontinence: Patients have no awareness of urination and usually urinate reflexively when the bladder is full, which is common in spinal cord injuries.

-Urge incontinence: Overactive bladder, causing urinary urgency or even too little time to urinate.

- Overflow incontinence: Reduced urination ability results in incomplete emptying of urine, resulting in repeated overflow of urine from the bladder.

3. Treatment of neurogenic bladder

-Medication:

1. Anticholinergics (such as tolterodine, oxybutynin): used to control overactive bladder.

2. α-blockers: help relax the bladder outlet sphincter and improve urination difficulties.

3. Local botulinum toxin injection: inhibit excessive contraction of bladder muscles and improve urinary incontinence.

-Behavioral and supportive therapy:

1. Urination training: urinate regularly to reduce the occurrence of urinary incontinence.

2. Pelvic floor muscle rehabilitation training (Kegel training): Strengthen the pelvic floor muscles and assist in urine control.

- Surgical intervention:

1. Bladder augmentation: Improve the storage capacity of the bladder.

2. Sphincter replacement: restore the control function of the bladder neck.

3. Urinary diversion surgery: For severe patients, a new urination channel is established through surgery.

-Lifestyle Adjustments:

1. Pay attention to avoid spicy foods and stimulating drinks (alcohol, coffee) in your diet to reduce the triggering of urinary urgency.

2. Drink enough water every day, but plan your drinking time to minimize the probability of nocturia or accidental urination.

Urinary incontinence caused by neurogenic bladder often affects the patient's quality of life. Reasonable diagnosis and treatment and early management are very important. If you cannot control your urine, you should go to the urology or neurology department of a regular hospital for examination and treatment as soon as possible. According to the doctor's advice, medication, behavioral training or surgical intervention can improve urination function and help patients return to normal life.