There are essentially two types of bladder dysfunctions: involuntary leakage of urine (urinary incontinence) and bladder emptying disorders. Patients either have difficulty emptying their bladder completely or they are unable to pass urine at all. In many cases combined disorders also occur. In order to determine the exact causes of a bladder disorder, an examination by a urologist is often necessary. In many cases, however, they also need to be clarified by a neurologist, especially if they occur together with symptoms such as dizziness, numbness , arm or leg weakness, or movement disorders.
Causes
Bladder emptying disorders can have a variety of causes, such as previous pelvic surgery, inflammation, or other problems with the prostate and urinary tract. Bladder voiding dysfunction can occur due to poor coordination between the bladder wall muscles and the bladder sphincter muscles. If the bladder sphincter contracts at the same time as the bladder, the bladder cannot empty.
However, they can indicate other serious conditions, such as changes in the spine resulting in pressure on the spinal cord. Bladder emptying disorders also occur when there is an injury to the nerve pathways between the spinal cord and the bladder, or when the bladder itself is injured. In some cases, medications such as those given for depression or strong pain medications, can also cause bladder emptying dysfunction. Bladder emptying disorders may also be a sign or accompanying symptom of a serious neurological disease (neurogenic bladder emptying disorders), such as multiple sclerosis, encephalitis, a stroke, Parkinson’s disease, narrowing of the spinal canal or paraplegia and diseases of the spinal cord. Bladder emptying problems are also seen in certain nerve disorders resulting from long-standing diabetes.
Treatment
Treatment of bladder dysfunction is important, partly because it can lead to ascending infections if untreated, i.e. infections that travel from the bladder to the kidneys. A variety of medications can be used in these conditions. The patient can also sometimes learn to drain urine regularly using a catheter before it ultimately becomes necessary to use a permanent catheter.
