Bladder Disorders

There are many different types of bladder disorders.

Bladder disorders can make everyday life difficult. Some of the most common bladder disorders include:

• Overactive bladder
• Stress urinary incontinence
• Neurogenic bladder conditions (brought on by neuro conditions or spinal injuries)

Overactive Bladder

A person with an overactive bladder needs to urinate more than seven times a day or has to urinate more than one time at night. Some other symptoms are leakage, strong urges to urinate, and not being able to hold or postpone the need to void.

The pelvic floor muscles and surrounding nerves and ligaments help to carry and control the bladder. The area can become injured during labor, continuous strenuous lifting, surgery, or certain chronic diseases. Aging can also be a factor.

Nonsurgical options for treatment are physical therapy, biofeedback, and pessaries. A pessary is somewhat like a diaphragm. It is inserted into the vagina. Bladder Botox injections and an acupuncture-style treatment called percutaneous tibial nerve stimulation (PTNS) may also be utilized to treat urgency and overactive bladder.

Surgical treatments may involve reconstruction or implanting a sling or tape. Mini-slings use a small piece of surgical mesh that support the neck of the bladder or urethra. The mesh can be synthetic or made of animal tissue, such as skin or intestines. Synthetic meshes can be a combination of absorbing and non-absorbing, while the animal tissue meshes are absorbing.

Stress Urinary Incontinence

Stress urinary incontinence is characterized by leaking during physical activity or when pressure is bared on the stomach area from laughing, sneezing, or coughing. The causes and treatments are similar to that of an overactive bladder. Injecting transurethral bulking material around the urethra helps to control leaking, although it might not be a permanent solution.

Lifestyle and behavior modifications for incontinence may include Kegel exercises, stopping smoking, and reducing some medications like diuretics and antihistamines if medically appropriate. Clothing options might also be recommended, such as adult diapers and pads. Females may have the option of inserting an absorbing plug vaginally.

Neurogenic Bladder

Neurological injuries or conditions can contribute to voiding issues, such as not being able to void or completely empty the bladder. Neurogenic bladder (NGB) symptoms can also include incontinence, urinary tract infections, pain in the pelvis, and possible breakdown of kidney function. A few of the disorders that cause neurogenic bladder are multiple sclerosis (MS), trauma, strokes, and Parkinson's disease.

There are some prescription drugs available. Anticholinergics and Botox are medications that relax the bladder muscle and prevent leaking. Injections of Botox into the bladder muscle help with urgency and frequency.

One surgical option for NGB is sacral nerve stimulation (SNS). A wire device is inserted near the sacral nerves innervating, the bladder. If it proves effective in the patient, a battery is implanted under the skin for long-term stimulation.

Once all other treatments are exhausted, surgery to expand the bladder's capacity can be performed in NGB patients. For example, a portion of the bowel can be used to expand the bladder capacity in a procedure called continent catheterizable stoma.