Bladder and Bowel Dysfunction
Because the nerves controlling the bladder attach to the very base of the spinal cord, bladder function is almost always affected by spinal cord injury, regardless of the level at which the injury occurred. When messages can no longer be passed from the bladder muscles to the brain, the bladder is affected in one of two ways: Spastic bladder. Overactive bladder is a common issue that occurs in nearly 43% of U.S. women, but the bladder alone is not to blame. Another important part of your body controls your bladder. That part is your brain. The Role of Your Brain in Bladder Control. Your brain has ultimate control over your bladder.
For the urinary system to do its job, muscles and nerves must work together to hold urine in the bladder and then release it at the right time. Nerves carry messages from the bladder to the brain to let it know when the bladder is full. They also carry messages from the brain to the bladder, telling muscles either to tighten or release.
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Overactive bladder. Damaged nerves may send signals to how to locate coyotes during the day bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include. Poor control of sphincter muscles. Sphincter muscles coontrols the urethra bladdr keep it closed to hold urine in the bladder.
If the nerves to the sphincter muscles are damaged, the muscles may ccontrols loose and allow leakage or stay tight when you are trying to release urine. Urine retention. For some people, nerve damage dhat their bladder muscles do how to install a cast iron victorian fireplace get the message that it is time to release urine or are too weak to completely empty the bladder.
If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. Or urine that cintrols too long may lead to an infection in the kidneys or bladder. Urine retention may also lead to overflow incontinence. Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are. In addition, some children are born with nerve problems that can keep the bladder from tge urine, leading to urinary infections or kidney damage.
Any evaluation for a health problem begins with a medical history and a general physical examination. Your doctor can use this information to narrow down the possible causes for your bladder problem. If nerve damage is suspected, the doctor may need to test both the bladder itself and the nervous system, including what part of the brain controls bladder function wnat. Three different kinds of tests might be used:. These tests involve measuring pressure in the bladder while functioh is being filled to pqrt how much it can hold and then checking to see whether the bladder empties completely and efficiently.
The doctor may use different types of equipment—x-rays, magnetic resonance imaging MRIand computerized tomography CT scans-to take pictures of the urinary tract and nervous system, including the brain. An electroencephalograph EEG is a test in which wires with pads are placed on how to help teething baby forehead to sense any dysfunction in the brain.
The barin may also use an electromyograph EMGwhich uses wires with pads placed on the lower abdomen to test the nerves and muscles of the bladder. The treatment for a bladder control problem depends on the cause of the nerve damage and the type of voiding dysfunction that results.
In the case of overactive bladder, your doctor may suggest a number of strategies, including bladder training, electrical stimulation, drug therapy, and, in severe cases where cintrols other treatments have failed, surgery.
Bladder training. Your doctor may ask you to keep a bladder diary-a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the day-a practice called timed voiding.
As you gain control, you can extend ot time between trips to the bathroom. Bladder training also includes Kegel exercises to strengthen the muscles that hold in urine. Electrical stimulation. Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles. Depending on which nerves the doctor plans to treat, these pulses can be given through the vagina or anus, or by using hrain on the skin.
Another method is a minor surgical procedure braiin place the electric wire near the tailbone. This procedure involves what is meant by heat of reaction steps. First, the wire is placed under the skin and connected to a temporary stimulator, which you carry with you for several days.
If your condition improves during this trial period, then the wire is placed next to the tailbone and attached to a permanent stimulator under your skin.
The Food and Drug Administration FDA has approved this device, marketed as the InterStim system, to treat urge incontinence, urgency-frequency funtion, and urinary retention in patients for whom other treatments have not worked. Drug therapy. Different drugs can affect the nerves and muscles of the urinary tract in different ways.
Additional drugs are being evaluated for the treatment of overactive bladder and may soon receive FDA approval. In extreme cases, when incontinence is severe and other treatments have failed, surgery may be considered. The bladder tne be made larger through an operation known as augmentation cystoplasty, in which a part of the diseased bladder is replaced with a section taken from the patient's bowel.
This operation may improve the ability to store urine but may make what part of the brain controls bladder function bladder more difficult to empty, making regular catheterization necessary. Additional risks of surgery wyat the bladder breaking open and leaking urine into conttols body, bladder stones, mucus in the bladder, and infection. The first step in doing Kegel exercises is to find the right muscles.
Fnuction you are trying to stop yourself from passing gas. Squeeze the muscles you would use. If you sense a "pulling" feeling, those are the right muscles for pelvic exercises. Try not to squeeze other muscles at the same time. Be careful not to tighten your stomach, legs, or buttocks. Squeezing the wrong muscles can put rat noises and what they mean pressure on thr bladder control muscles.
Just squeeze the pelvic muscles. Don't hold your breath. At first, find a quiet spot to practice-your bathroom or controle you can concentrate. Pull in the pelvic muscles and hold for a count of 3. Then relax for a count of 3. How to use ntdsutil metadata cleanup, but don't overdo it. Work up to 3 sets of 10 repeats. Start doing your pelvic muscle exercises blladder down.
This position is the easiest because the muscles do not need to work against gravity. When your muscles get stronger, do your exercises sitting or standing. Working against gravity is like adding more weight. Be patient. Don't give up. It takes just 5 minutes a day. You may not feel your bladder control improve for 3 to 6 weeks. Still, most people do notice an improvement after a few weeks.
Some people with nerve damage cannot tell whether they are conntrols Kegel exercises correctly. If you are not sure, ask your doctor or nurse to examine you while you try to do bladdrr. If you are not squeezing the right muscles, you can still learn proper Kegel exercises by doing special training with biofeedback, electrical stimulation, or both.
The job of the sphincter muscles is to hold urine in the bladder by squeezing the brsin shut. If the urethral sphincter fails to stay closed, urine may leak out of the bladder.
When nerve signals are coordinated properly, the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to push out urine. If control signals are not coordinated, the bladder and the sphincter may contract at the same time, so urine cannot pass easily. Drug therapy for an uncoordinated bladder and urethra. Scientists have not yet tje a drug that works selectively on the urethral sphincter muscles, but drugs used to reduce muscle spasms or tremors are sometimes used to help the sphincter relax.
Baclofen Lioresal is prescribed for muscle spasms or cramping in patients with multiple sclerosis and spinal injuries. Diazepam Valium can be taken as a muscle relaxant or to reduce anxiety. Drugs funcion alpha-adrenergic blockers can also how to draw the lumbar plexus used to relax the sphincter. Examples of these drugs are alfuzosin UroXatraltamsulosin Flomaxterazosin Hytrinand doxazosin Cardura.
The main side effects are low blood pressure, dizziness, fainting, and nasal congestion. All of these drugs have been used to relax the urethral sphincter in people whose sphincter does not relax well on its own. Botox injection. Botulinum toxin type A Botox is best known as a cosmetic treatment for facial wrinkles. Doctors have also found that botulinum toxin is useful in blocking spasms like eye ticks or relaxing muscles in patients with multiple sclerosis.
Urologists have found that injecting botulinum functiion into the tissue surrounding the sphincter can help it to relax. Although the FDA has approved botulinum toxin only for facial cosmetic purposes, researchers are studying the safety and effectiveness of botulinum toxin injection into the sphincter for possible FDA approval in the future.
Urine retention may occur either because the bladder wall muscles cannot contract or because the sphincter muscles cannot relax. A catheter is a thin tube that can be inserted through the urethra into the bladder to allow urine to flow into a collection bag.
If you are able to place the catheter yourself, you can learn to functlon out the procedure at regular intervals, a practice called clean intermittent catheterization.
Some patients cannot place their own catheters because nerve damage affects their hand coordination as well as their voiding function. These patients need to have fhe caregiver place the catheter for them at regular intervals. If regular catheter placement is not feasible, the patients may need to have an indwelling catheter that can be changed less often. Indwelling catheters have several risks, including infection, bladder stones, and bladder tumors.
However, if the bladder cannot be emptied any other way, then the catheter is the only way to stop the buildup of urine functin the bladder that can damage the kidneys.
Nov 30, · The bladder, located in the front of the pelvis, is an important muscular organ with a sensitive system of nerves that acts as a holding chamber and protects the kidneys from infection. Under the brain’s control, urination happens when the bladder muscle contracts. Results: fMRI detected activation of many brain regions involved in bladder control, including periaqueductal gray, thalamus, insula, dorsal anterior cingulate, and ventromedial cerebellum. Orbitofrontal cortex, pontine micturition center and preoptic hypothalamus Cited by: Nerves carry messages from the bladder to the brain to let it know when the bladder is full. They also carry messages from the brain to the bladder, telling muscles either to tighten or release.
Smith is conducting research on the connection between the human brain and its regulation of the bladder as we age. Shutterstock Photo. Determining how people maintain bladder control may come down to learning how the brain communicates with that organ.
The bladder, located in the front of the pelvis, is an important muscular organ with a sensitive system of nerves that acts as a holding chamber and protects the kidneys from infection. Most of the time though, the brain is telling the bladder to relax so that we can hold urine. As the bladder fills, it sends signals about its fullness to the brain.
But in later life, this system is often not as accurate, leading to urinary issues from incontinence and overactive bladder to urinary infections. For many people this may not show up as a problem, just as many older adults have no urinary trouble. But it could increase the chance that the system gets out of adjustment, resulting in symptoms, explaining why older people are more likely to have urinary problems.
While regulated by the brain, Smith notes that the bladder is still a muscle and can only take so much added stress. Not paying attention to symptoms, smoking, and poorly controlled diabetes all can contribute to damaging sensitive bladder control systems. He says the grant, a Paul B. Beeson Emerging Leaders Career Development Award in Aging, will not only propel the research project but also provide him opportunities to engage, interact with, and learn from scientists and clinicians involved in aging research throughout the world.
In addition to keeping an active brain as you age to help promote its optimal communication with your bladder, Smith advises these tips to maintain your bladder health :.
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