Can neurogenic bladder be cured

Many people may not be so clear about the disease of neurogenic bladder. In fact, the incidence of this disease is becoming more and more high, causing a lot of people to suffer from this disease. When it occurs, patients will feel that they often have difficulty urinating, which is quite dangerous. If it continues for a long time, it will cause some bacterial infections in their urethra.

1. Intermittent catheterization or continuous drainage: Intermittent catheterization can be used in patients in the spinal shock period after spinal cord injury or with a large amount of residual urine or urinary retention, if the renal function is normal. Initially it was performed by medical staff. If the patient's general condition is good, the patient can be trained to catheterize himself. Intermittent catheterization is more appropriate in women. If various surgical treatments are ineffective, intermittent catheterization can be performed at home for life. If the patient's general condition is poor or renal function is impaired, an indwelling catheter should be used for continuous drainage.

2. Drug treatment: Patients with a large amount of residual urine in the bladder, regardless of whether they have symptoms of detrusor hyperreflexia such as frequent urination, urgency, and urge incontinence, should first use alpha-blockers to reduce residual urine. If the effect of α-receptor blockers alone is not good, drugs such as urethane and neostigmine that increase bladder contractility can be used simultaneously.

For patients with symptoms of detrusor hyperreflexia (frequent urination, urgency, enuresis) but no residual urine or very little residual urine, drugs that inhibit bladder contraction such as urodolin, verapamil, propantheline, etc. can be used. For patients with mild stress urinary incontinence but no residual urine, drugs such as ephedrine and propranolol that promote contraction of the bladder neck and posterior urethra can be used. For patients with impaired urinary function, measures should be taken first to ensure smooth urine drainage rather than using drugs to improve urination symptoms.

3. Acupuncture therapy Acupuncture has a good effect in treating sensory paralysis bladder caused by diabetes, and is particularly effective for early lesions.

4. Block therapy: This method was advocated by Bors and is suitable for upper motor neuron lesions (detrusor hyperreflexia). It is not very effective for motor neuron disease (detrusor areflexia). For those who achieved good results after closure, the residual urine volume was significantly reduced and the urination symptoms were significantly improved. For a few patients, the effect can last for several months to a year after one closure. These patients only need regular local care and no surgery is required.

The blockade therapy is performed in the following order: ① Mucosal blockade: Empty the bladder with a catheter and inject 90 ml of 0.25% pantocaine solution, which will be discharged after 10 to 20 minutes. ② Bilateral pudendal nerve block. ③Selective sacral nerve block: block a pair of sacral nerves in S2~4 each time. If there is no effect, S2, S4 and S4 combined block can be performed.

4. Bladder training and expansion can be used to treat patients with severe symptoms of frequent urination and urgency, with no residual urine or very little residual urine. Instruct the patient to drink water regularly during the day, 200 ml per hour. Try to extend the time between urinations to allow the bladder to expand gradually.