Neuro Urology is the study of the mechanisms of Nervous control for complete and efficient passage of urine .
Bladder is a hollow organ located in lower abdomen that helps to store and empty urine at periodic and convenient timing.
Neurological conditions like stroke, spinal cord tumors spinal cord injury, disc prolapse, etc. can affect bladder function resulting in neurogenic bladder.
Depending on underlying neurological damage, bladder may be OVERACTIVE ( Neurogenic bladder ) with retention of urine, or under active described as urinary incontinence .
Symptoms of Neurogenic Bladder?
Inability to initiate urination.
Frequent urination and small quantity of urine.
Straining to urinate.
How is Neurogenic Bladder diagnosed?
Apart from detailed history and physical examination your doctor may order tests called Urodynamic studies to diagnose Neurogenic Bladder.
Urodynamic studies (Bladder Function Tests) are conducted to measure bladder capacity, bladder pressure, urine flow and bladder emptying.
A cystoscopy may be performed to examine the inside of bladder and urethra with a small telescope to identify the effects of impaired bladder functions and the effects of long standing stasis of urine like stone formations, infections etc.
How is Neurogenic Bladder treated?
There are many types of treatment for Neurogenic Bladder. The appropriate treatment for an individual is determined by symptoms, type & extent of nerve damage and discussion with the patient about their requirements .
1. Physical and Psychological Therapy: It is also called fixed voiding, combines will power and exercise. It helps you to gradually improve your control over urination.
2. Drug Therapy: There are certain drugs that reduce bladder contractions, e.g. Tolterodine Tartrate, Bethanacol Sodium which improve the bladder contractions.
3. Clean Intermittent Self Catheterization: Patients can insert Catheters through urethra into bladder to drain urine. This treatment is called Clean Intermittent Catheterization (CIC).
4. Artificial Sphincters: Consists of creation of an artificial cuff that fits around bladder neck to control urination.
5. Urinary Diversion: Creates a stoma (opening) through which urine is sent to a collection pouch.
Bladder Augmentation:Segments of intestine are removed and attached to wall of bladder to reduce bladder pressure and improve bladder capacity.
Sphincterotomy: Urinary sphincter can be surgically weakened to improve bladder emptying.
Electrical Stimulatory Therapy: Here electrodes are placed near nerves supplying the bladder. Bladder storage and emptying is improved by stimulating these electrodes.