What is a Nervous Bladder?

The bladder is very resistant to bacteria. Bacteria are also difficult to enter the bladder, and even if they enter, they will be eliminated from the body with urine and will not cause infection. However, when upper urinary tract infection, lower urinary tract obstruction, and decreased bladder resistance, the bladder mucosa is susceptible to infection, destroying nerves, causing disorders in bladder function, and causing neurological bladder inflammation such as spasms.

Neurocystitis

This entry lacks an overview map . Supplementing related content makes the entry more complete and can be upgraded quickly. Come on!

Central nervous system that controls urination or

Neurogenic bladder consists of two parts. First, it should be clear whether dysuria is caused by neuropathy, and secondly, neurogenic.

I. Non-surgical Therapy

1. Intermittent catheterization or continuous drainage in the spinal cord shock period after spinal cord injury or a large amount of residual urine or urinary retention, such as normal renal function, intermittent catheterization can be used. Initially operated by medical staff. If the patient's general condition is better, the patient can be trained to self-catheterize. Intermittent catheterization is more appropriate in women. If all kinds of surgical treatments are ineffective, they can perform intermittent urinary catheterization for their entire lives. If the patient's general condition is poor or the kidney function is damaged, an indwelling catheter is used for continuous drainage.

2. Drug treatment For patients with a large amount of residual bladder urine, whether or not they have symptoms of detrusor hyperreflexia such as frequent urination, urgency, and urgency incontinence, alpha receptor blockers should be applied first to reduce residual urine. If the effect of alpha blocker alone is not good, urethane, neostigmine, and other drugs that increase bladder contractility can be used simultaneously. For patients with detrusor hyperreflexia (frequent urination, urgency, enuresis) without residual urine or very little residual drugs, drugs that inhibit bladder contraction, such as urinary polydox, isacardia, probencin, etc. For those with mild stress urinary incontinence without residual urine, drugs such as ephedrine and propranolol to promote bladder neck and posterior urethral contraction can be applied. For patients with impaired renal function, measures should first be taken to make the urine flow more smooth, rather than using drugs to improve the symptoms of urination.

3. Acupuncture therapy Acupuncture has a good effect on the sensory paralytic bladder caused by diabetes, and it is especially effective for early lesions.

4. Closure therapy This method is suitable for upper motor neuron disease (hypertrophic detrusor reflex). It is not effective for motor neuron disease (no detrusor reflex). Those with good results after closure had significantly reduced residual urine volume and significantly improved micturition symptoms. In a few patients, the effect can be maintained for several months to one year after being closed once. These patients only need to perform local production on a regular basis without surgery.

5. Bladder training and dilation are severe for frequent urination and urgency, and those with no residual urine or very small residual volume can be treated with this method. Instruct patients to drink water regularly during the day, 200ml per hour. Extend the interval of urination to make the bladder easy to gradually expand.

2. Surgical treatment: Surgical treatment is generally performed after non-surgical treatment is ineffective and after the neuropathy has stabilized. Based on the results of urodynamic tests, the location and nature of the functional lower urinary tract obstruction were determined, and surgery was performed to remove the obstruction. Principles of surgery Mechanical obstruction in the urinary system (such as benign prostatic hyperplasia), mechanical obstruction should be removed first. In patients with detrusor nonreflex, first consider transurethral incision of bladder neck. Patients with detrusor hyperreflexia, or those with detrusor sphincter dysfunction, such as pudendal nerve block, have only a temporary effect, which can be used for transurethral sphincterotomy or resection. In patients with detrusor hyperreflexia, if the selective phrenic nerve block has a short-term effect, the corresponding phrenic nerve absolute alcohol injection or the corresponding phrenic nerve root resection can be performed. Severe urinary frequency and urgency symptoms (emergency urination syndrome), no residual urine or small amount of residual urine, those who have no effect after drug treatment, closed therapy, bladder training and dilatation may consider bladder nerve ablation or transbladder Inject the pelvic nerves on both sides of the bottom of the bladder with absolute alcohol or 6% carbolic acid. Patients with detrusor hyperreflexia, such as various closure treatments have no effect, for bladder neck incision. Posterior urethral incision: This technique is only suitable for men. It causes the patient's internal urethral sphincter to lose the function of controlling urine outflow in the bladder, resulting in non-resistance urinary incontinence and urine drainage. Patients need to collect urine with a penis cover and urine collection bag for life. With this procedure, complications such as urinary tract infections have fallen below 1%. The disadvantage is that patients are less convenient in life.