Bladder Problems – Spina Bifida

old woman in a wheel chair with nurse

Bladder Problems

Many people underestimate the bladder’s importance and what is required to keep the organ healthy. In conjunction with the rest of the urinary system (kidneys, ureters, and the urethra), the bladder has the important function of storing urine until the body is ready to urinate. Due to factors such as lifestyle habits and bacteria entering the body, the bladder is often ignored until a problem arises in the urinary system. Typically, the most common and recognizable bladder problem is a urinary tract infection. This infection occurs when bacteria enters through the urethra and into the bladder, or the bladder is unable to empty properly, which leaves residual urine in the bladder that can become infected. Bladder infections are the most common form of urinary tract infections, but infections can also occur in the kidneys and urethra. If infection in the kidneys occurs, it can lead to severe problems and cause permanent damage to the kidneys if it happens frequently or is not attended to quickly. An infection in the urethra is possible but is less common.

Even more serious forms of bladder problems are urinary incontinence, which is a lack of bladder control and urine leakage, and urinary retention, an inability to empty the bladder properly. These two types of bladder problems can be caused by an array of factors including neurogenic disorders. These neurogenic disorders include an injury to the spinal cord, multiple sclerosis (MS), and spina bifida (a birth defect of the spine that often causes paralysis). Urinary incontinence and retention can also be happening due to the consequence of an underlying physical disease caused by an irregularity in the bladder. It can be related to old age as well. Bladder cancer, which is found in the lining of the bladder, is also a serious medical issue that involves blood in the urine, lower back pain, and a persistent urge to urinate.

If neurogenic disorders, such as multiple sclerosis or spina bifida, are experienced along with either urinary retention or incontinence, this is known as neurogenic bladder. This condition is simply the term for when normal control over the bladder is lost, caused by damage to the central nervous system. People living with neurogenic bladder are usually affected in one of two ways. Flaccid bladder is when the bladder is excessively and overly stretched, which allows exceedingly large quantities of urine to be reserved before exiting the body. The bladder stretches and can hold a limit of 2000 milliliters of urine, which may lead to leakage of the urine. In some illnesses or disorders, such as spina bifida, flaccid bladder will usually occur in combination with a complication of a sphincter muscle that will not open. On the other hand, spastic bladder happens when the bladder is very stiff, which means the bladder is not able to stretch as it should. Therefore, the bladder cannot hold the amount of urine that is considered normal as well. The bladder also may not be able to empty properly. This increases the chance of a urinary tract infection, since the urine that is left behind serves as a pool for bacteria to grow and thrive in the bladder.


Symptoms of Bladder Problems

The symptoms of the bladder and urinary problems are dependent on the underlying cause(s) and which bladder problem a person is being affected by. Below are what the symptoms are of the above-mentioned problems with the bladder:

Urinary tract infections can include symptoms such as bloody, foul-smelling, or cloudy urine; feeling the strong need to urinate frequently, even when the bladder is already empty; burning sensation or pain while urinating; and/ or a mild fever in some individuals. If a urinary tract infection spreads to the kidneys, symptoms can include feeling tired or generally ill; night sweats; very bad abdominal pain in some individuals; fever above 101 degrees Fahrenheit; aching in the back, groin, or side; flushed, reddened, or warm skin; and/ or nausea and vomiting.

Symptoms of urinary incontinence can include small or large quantities of urine leaking without warning or without feeling the urge to go to the toilet; the requirement to wake up to pass urine two or more times during the night (known as nocturia); an unexpected urge to get to the toilet to urinate; and involuntarily leakage when sneezing, coughing, laughing or exercising.

Individuals living with urinary retention can experience a weak flow of urine; an urgent sense to urinate but inability to start the urine flow; discomfort; a feeling of bloat in the lower abdomen; dribbling because of overflow incontinence; and/ or numerous visits to the toilet.

Typical symptoms of spastic bladder can include the need to empty the bladder frequently, uncontrolled leakage, spontaneous emptying.


Causes

Medical conditions creating bladder or urinary issues are typically categorized as either neurogenic or non-neurogenic conditions. Some conditions may cause urinary retention, or the conditons may prevent the bladder from emptying completely and require a form of treatment. For the conditions that can cause urinary incontinence, collecting devices, or a urisheath and bag, offer comfortable solutions for men. There are also special pads available, which are designed specifically for women that have urinary incontinence.

Some conditions that eventually or immediately result in damage to the nervous system include injury to the spinal cord, stroke, diabetes mellitus, multiple sclerosis (MS), and spina bifida. Symptoms of these conditions can widely vary based on where the neurological injury occurs and what level of severity the injury is.

There are other medical conditions that cause bladder issues as well. An example of a non-neurogenic medical condition producing bladder and urinary problems is benign prostatic hyperplasia (BPH), also known as an enlarged prostate. Benign prostatic hyperplasia can have a huge impact on men who are diagnosed with this condition and their daily lives, as urinary symptoms may appear as the prostate grows. Symptoms can become very bothersome, and if severe enough, an intermittent catheter, medicine or an operation may be needed.

Other non-neurogenic medical conditions that can cause bladder problems involve benign prostatic hyperplasia or enlarged prostate; enfeebling of the pelvic floor due to age, pregnancy, and/ or childbirth; surgery on the prostate or bladder; bladder cancer; aging; and botox injections of the bladder to control urinary incontinence.


Catheters

Some people who suffer from specific bladder problems may find that they prefer to use catheters compared to other forms of treatments. In some cases, these medical devices prove to be the most effective treatment, especially for those experiencing urinary incontinence or retention. Many options are available for both men and women, and what catheter is right for every person depends on what is recommended by doctors’ orders and what adequately accommodates every lifestyle. Intermittent catheterization includes inserting and removing a catheter multiple times a day, whenever the bladder needs to be emptied. This form of catheterization is one of the most favored forms of catheterization due to this method resulting in less infections in the bladder and the rest of the urinary system. A sterile catheter is inserted into the urethra and then into the bladder every time urine must be passed and does not require a collection method for urine. However, if a urinary collection bag would suit someone else’s lifestyle better, indwelling catheters, such as the Foley catheter, work well for some bladder problems as well. Indwelling catheters are catheters that are not removed from the urethra and usually involve urinary collection bags. These bags are either fastened to the ankle, thigh, or stomach and are typically easy to hide under clothing. Other forms of catheters include external catheters, stoma catheters, and other types of urinary collection bags.


When to Consult a Healthcare Professional

Those individuals who live with or experience problems with the bladder may put off going to see a healthcare professional due to any embarrassment they may feel about their conditions. However, bladder problems are more common than what some people may think. In some cases, having an issue with the bladder may be an indication of a more significant and potentially hazardous health condition. Therefore, listening to the bladder and informing healthcare providers of urinary changes should be taken very seriously.

Bladder problems can be caused by many factors, including numerous medical conditions and injuries. These issues may also be an indication that another area of health needs attention.