Neurogenic bladder dysfunction

Neurogenic bladder dysfunction is a urinary system disease. When it occurs, it will have a certain impact on a person's normal urination function. In addition, it may also cause complications such as urinary tract infection, urinary stones or vesicoureteral reflux, so active treatment is very important for patients. Next, I will introduce you to the disease of neurogenic bladder dysfunction.

1. Symptoms and Signs

1. The symptoms of detrusor hyperreflexia are caused by uninhibited contractions, mainly frequent urination, urgency and urge incontinence. Some patients present with stress urinary incontinence or enuresis.

2. Patients with detrusor areflexia cannot open or open the bladder neck fully during urination, often showing symptoms such as dysuria, urinary retention, and overflow incontinence.

3. In addition to urination symptoms, there may be other symptoms such as constipation, fecal incontinence, decreased or loss of perineal sensation, and limb paralysis.

2. Complications

Urinary tract infection is the most common complication of neuropathic bladder. Urinary tract stones may occur in 10% to 15% of patients. Vesicoureteral reflux occurs in 10% to 40% of neuropathic bladder and is usually reversible. It may improve on its own when urination improves, residual urine decreases, and bladder pressure decreases.

3. Physical Examination

① Anal sphincter tension test: Relaxation of the anal sphincter indicates inactivity or reduced activity of the spinal cord center. Excessive contraction of the anal sphincter indicates hyperreflexia of the spinal cord center.

② Anal reflex test: Stimulate the skin around the anus. If the anus contracts, it indicates the presence of spinal cord activity.

③ Bulbospongiosus reflex test: Stimulating the glans penis or clitoris will cause contraction of the anal sphincter, indicating the presence of spinal cord activity.

IV. Treatment Methods

The purpose of treatment is to protect renal function; to establish low-pressure urine storage, urination and urination control to relieve symptoms and improve quality of life; and to deal with complications such as urinary tract infection. The treatment idea is to promote urine storage or urination by intervening in bladder and urethral function. The treatment method is to promote urine storage or urination through surgical or non-surgical methods, emphasizing the individualization of treatment plans; paying attention to the treatment of the primary disease. As there is no completely satisfactory treatment method so far, simple, safe and less damaging treatment methods should be given priority, provided that the treatment effect is achieved.