Neurogenic bladder

For study and Discussion

1. NEUROGENIC BLADDER PRESENTER DR. MUHAMMAD HUSNAIN

2. ANATOMY OF BLADDER

3. DEFINITION : “Neurogenic bladder refers to dysfunction of the urinary bladder due to disease of the central nervous system or peripheral nerves involved in the control of micturition.”

4. FLACCID BLADDER “ A flaccid, or hypotonic, bladder ceases to contract fully, causing urine to dribble out of the body . Besides the complications that stem from urine dripping, rashes can occur in the area where urine pools. This type of bladder disorder occurs when the volume of urine is large but the pressure is low.”

5. SPASTIC BLADDER “A spastic, or reflex, bladder occurs when the volume of urine is normal or small, but there are involuntary contractions , causing a person to feel the need to urinate even when he doesn't need to release urine.”

6. Causes of Neurogenic Bladder Stroke Parkinson’s disease Multiple sclerosis Alzheimer’s disease Spina bifida and neural tube defects Disorders resulting from diabetes Alcoholism

7. Nerve damage may result from: Child birth Pelvic injury Brain or spinal cord injury Herniated disc Heavy metal poisoning Tumors of the Brain, spinal cord or pelvis

8. Symptoms of Neurogenic Bladder Overactive bladder Frequent urination, in the daytime and at night ( nocturia ) Stress incontinence Urge incontinence Inability to urinate (urinary retention) Underactive bladder – bladder is unable to signal when full

9. Etiology And Risk Factors Tumors Neurologic disorders Trauma to the nervous system Clinical Manifestations Retention with or without incontinence The patient may or may not feel a need to void or feel a sense of bladder distension.

10. Treatment Medicines that relax the bladder (oxybutynin, tolterodine, or propantheline) Medicines that make certain nerves more active ( bethanechol ) Botulinum toxin (Botox) GABA supplements Antiepileptic durgs Exercises to strengthen your pelvic floor muscles (Kegel exercises)

11. Sometimes surgery is needed. Surgeries for neurogenic bladder include: Artificial sphincter Electrical device implanted near the bladder nerves, to stimulate the bladder muscles Sling surgery Creation of an opening (stoma) in which urine flows into a special pouch (this is called urinary diversion) Treatment

12. SPASTIC NEUROGENIC BLADDER

13. FLACCID NEUROGENIC BLADDER

14. THANKS