Bladder Problems – Spina Bifida

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.

What Causes Urinary Incontinence

What is Urinary Incontinence?

Urinary incontinence is involuntary bladder leakage of any kind and an overall loss of bladder control, which can make everyday life uncomfortable. Urinary incontinence is not a disease or illness but rather an indicator of other underlying bodily and health problems that are occurring in the body. There can be many factors that need to be taken into account while treating this issue, and it is a condition that is more common that you may know.


What Causes it?

The causes of urinary incontinence can vary and depend on multiple aspects. Firstly, temporary incontinence can occur due to consumption of certain foods and drinks. Alcohol, caffeine (i.e. coffee or tea), high sugar content, smoking, and some medications such as muscle relaxers can all cause irritations in the bladder. Diabetes, stroke, Multiple Sclerosis, and Parkinson’s disease can also be major causes, as well as surgery, menopause, and obesity. Essentially, anything that is interfering with the urinary system working correctly can cause urine to leak and loss of bladder control.

Urinary incontinence is a problem that is more associated with women, but men can experience this issue as well. In women, stress incontinence is usually experienced the most. Stress incontinence is experienced when any movement such as sneezing, laughing, coughing, bending, lifting, or physical activity such as running puts pressure on the bladder and causes urine to leak. This type of urinary incontinence can happen to women who have been pregnant and gone through childbirth, cystocele and pelvic organ prolapse, and menopause. Urge incontinence, also called overactive bladder, is another type of urinary incontinence women can sometimes experience, where the overwhelming urge to urinate is felt very suddenly and cannot be ignored or stopped.

It is a reasonable question to ask why incontinence affects women more than men and why factors such as pregnancy or menopause play a part. After pregnancy and childbirth, either by vaginal or c-section delivery, the pelvic floor muscles that support the bladder, urethra, uterus (womb), and bowels may become weaker or damaged. When the muscles that support the urinary tract are weak, those muscles in the urinary tract must work harder to hold urine until you are ready to go to the bathroom. This extra stress or pressure on the bladder and urethra can cause urinary incontinence or leakage. As previously mentioned, women experiencing menopause are at risk of developing urinary incontinence as well. This may be due to the drop in the estrogen hormone.
In men, the most common type of incontinence men experience is overflow incontinence, which happens when the bladder is full. It is rare in women and more common in men who have problems with the prostate. Constant dribbling and feeling the need to go to the bathroom are often common symptoms. Men with prostate gland problems are at an increased risk of urge incontinence as well. The most common cause of incontinence in men is prostate surgery. Other medical conditions that men may have that cause urinary leaking are prostate cancer and enlargement of the prostate gland. For both women and men, injury to the nervous system, birth defects, and physiological problems associated with aging can cause incontinence. In some instances, some people both leak urine with activity (stress urinary incontinence) and also feel the urge to urinate often (overflow urinary incontinence), a condition known as mixed incontinence. Medical conditions that are easily treatable such as urinary tract infections and constipation can also trigger some kinds of incontinence.


How is Urinary Incontinence Diagnosed?

Diagnosis can include your doctor giving you a physical examination and inquiring about past medical history. If your doctor thinks you are experiencing stress incontinence, for example, you may be asked to cough with a full bladder to see if any urine leaks; this is simply known as a stress test. Some questions about past medical histories may include how often you empty your bladder, how much urine is leaked, and what kind of medications you take. Doctors may diagnose the type of urinary incontinence you are experiencing based on your medical history and the physical exam. They may also use this information to decide if more testing is needed for you. Other kinds of tests are urinalysis and urodynamic tests. Urinalysis is when your urine sample is sent by your doctor or nurse to the lab and tested to find the source of any infections or complications. Urodynamic tests include several painless tests that will assist your doctor in understanding how your urinary system is functioning, including a test that lets your doctor to measure the pressure in your bladder, in order to see what level of fluid your bladder can hold. An ultrasound may also be needed to take pictures of the kidneys, bladder, and urethra to see if there is anything causing complications.

In some cases, your doctor may find that what is causing the leakage can be corrected easily. Impacted stool, restricted mobility, and certain medications you may be taking are other causes that are simple to fix. Pads or diapers can prevent embarrassing leaks, but other treatment options may be a better fit for your condition and experience.


What Are Treatment Options?

Regardless of what kind of incontinence you have and its level of severity, you should talk to your doctor and work together to create a unique treatment plan that will be effective in treating you specifically. Starting out with treatment may be as easy as taking steps from home, such as losing weight or changing your diet. Watching what you drink in a day is also a key part of treatment. Drinking six to eight glasses of water per day may be recommended to you, which can help reduce bladder irritation. Staying away from and/ or limiting drinks such as fruit juices and coffee may be required. Some form of bladder training may prove to be effective as well; keeping track of how often you urinate and when you have leakage are the first steps. Getting a more regular routine down with less visits to the bathroom should gradually make leaking less of a problem. For men and women especially who have minor medical conditions or irritations, strengthening the pelvic floor muscles can be effective in treatment for some cases. Exercising the pelvic floor can be done by doing kegel exercises regularly; this exercise should be done about three times a day, and it can be beneficial for some.

Other treatments may be recommended if these steps do not improve your condition, depending on what your doctor thinks will be the best for your health. More intensive treatments include: medication, medical devices such as a urethral insert or a pessary, interventional therapies such as botox and nerve stimulators, or surgeries, which is not recommended for women who plan on becoming pregnant in the future. Other options such as absorbent pads are very effective when experiencing leaks and are often not bulky or uncomfortable.

If you are experiencing incontinence due to your bladder not emptying properly, you may need to learn to use a catheter. Catheters are soft tubes that are inserted into the urethra until it reaches the bladder and drains the urine. Catheters and other supplies can be bought at medical supply stores, and you will get a prescription for the right catheter for you. There are many different types and sizes. Some catheters are meant to be used only once, and others can be reused if cleaned appropriately. Most insurance companies will pay for you to use a sterile catheter for each use. If you are reusing your catheter, you must clean it every day. There are also catheters called “indwelling” catheters that can be kept in day and night if it is suitable for your conditions. Catheters as a method of treatment for incontinence can be used for any type of urinary incontinence, and it may be the best course of action for you if other treatments are not effective. Talking to your doctor about which specific catheters and available treatments for incontinence are right for you is highly recommended.