Bladder Disorders
Bladder disorders include neurogenic bladder and overactive bladder. Each of these conditions is evidenced by unique conditions and requires personalized treatment.
Neurogenic Bladder
- Urinary incontinence (inability to control urine)
- Dribbling urine
- Kidney stones
- Urinary frequency
- Urinary urgency
- Urinary retention
- Urinary tract infection (UTI)
- Small urine volume during voiding
- Inability to sense the bladder is full
A neurogenic bladder may be caused by the following underlying conditions and factors:
Diabetes
Heavy metal poisoning
Brain or spinal cord tumors
Infections
Genetic nerve problems
Birth defects that affect the spinal cord
Accidents that cause injury to the brain or spinal cord
To diagnose a patient with neurogenic bladder, the physician will need to review exams of the brain, spinal cord, and bladder. Additional tests that may be
necessary include X-rays of the skull and spine, imaging tests of the bladder and ureters, cystoscopy to examine the urinary tract, ultrasound to visualize the organs, and urodynamic testing to see how much the bladder can hold.
Treatment for neurogenic bladder disorder may involve intermittent or continuous catheterization to drain the bladder. Other treatment options include placement of an artificial cuff around the bladder neck, preventative antibiotics to reduce infection, surgery to remove stones or blockages, and Botox injections into the bladder muscle.
Overactive Bladder
Patients with an overactive bladder experience sudden, powerful urges to urinate, often struggling to overcome them, leading to incontinence. Frequent urination at night is another symptom.
Overactive bladder may be caused by involuntary contraction of the muscles that empty the bladder when it isn’t full. The exact cause of overactive bladder may be
unknown in some cases. In other instances, the condition may be linked to excessive fluid consumption, diabetes, obesity, the use of diuretics, or cognitive impairment due to stroke or Alzheimer’s disease. The risk of developing overactive bladder is increased by the following factors:
Urinary tract infection
Neurologic disorders or damage to the signals between the bladder and brain
Pelvic muscle weakness or spasms
Side effects from a medication
Hormone changes
Diseases that affect the brain or spinal cord, such as stroke and multiple sclerosis
To diagnose overactive bladder, a physician will ask questions about the patient’s medical history and lifestyle. A physical exam will also be done to feel the patient’s abdomen, organs in the pelvis, and rectum.
A urine test, bladder scan, cystoscopy, and urodynamic testing may also be done to give the physician a more detailed picture of the patient’s condition.
Treatment for overactive bladder may involve Kegel exercises, weight loss, medication, intermittent catheterization, Botox injections, and surgery.
Sacral Nerve Stimulation
Patients with overactive bladder may be treated with sacral nerve stimulation. Treatment addresses issues with the sacral nerve using a bladder pacemaker, preventing symptoms.
An electrical wire will be implanted under the skin in the patient’s lower back, and connected to a handheld pacemaker that will send electrical pulses to the sacral nerve. The pacemaker will be tested for effectiveness and if the patient experiences improvement, then a second procedure will be done to implant a permanent pacemaker.
