Neurogenic bladder: causes
Neurogenic bladder dysfunction in children is a fairly common problem, on average it occurs in 10% of babies. This disorder greatly influences the development of various diseases of the urinary system, such as pyelonephritis, chronic cystitis, chronic renal failure, etc.
Neurogenic bladder in children does not represent an immediate threat to life, but socially this is a very important problem that can create a lot of problems with the adaptation and socialization of the child, affecting the activity of his communication with peers and self-confidence.
In fact, the neurogenic bladder in children (NRM) is a collective concept that combines a large group of disorders of its evacuation and reservoir functions. These disorders develop due to damage to the smooth muscles of the bladder, disorders of the nervous system of different levels and depth or changes in the structure of uroepithelium.
Neurogenic bladder: symptoms
The neurogenic bladder manifests itself in two types of urination disorders:
- retention of urine;
- urinary incontinence.
The signs of the neurogenic bladder differ depending on the level and depth of the nervous system.
Children can not arbitrarily regulate urination on average up to 2-2.5 years. Until this age, its emptying is controlled by the reflectron, sacral spinal cord. If reflex urination is observed at an older age, we can talk about the periodic incontinence of urine. The bladder is emptied without any regulation, automatically.
As a rule, urinary incontinence in children (neurogenic hyperreflex urinary bladder) is divided into the following types:
- imperative (sensory and motor);
- stressful;
- reflex;
- from overflow.
Parents who have noticed urinary incontinence in a child, it is worth paying attention to the following features:
- The time when incontinence occurs.
- Regularity and frequency of recurrence of incontinence episodes.
- Concomitant factors.
Bedwetting in children stands out in a separate pathology - nocturnal enuresis.
Separately, it is worth paying attention to the manifestations of incontinence in children who previously could consciously control urination and did not have head and back injuries. This may indicate a serious discomfort in the work of the nervous system.
Neurogenic bladder: treatment
All treatment options for bladder dysfunction can be divided into the following groups:
- non-drug treatment (training of the bladder, exercises for pelvic muscles, physiotherapy methods, etc.);
- pharmacotherapy;
- surgery.
Any scheme of treatment of NRM begins with the appointment of the most non-traumatic and simple treatment options, giving as little as possible side effects. We recommend a protective regime with a minimum of stresses, experiences, excluding psycho-traumatic situations. Showing also the refusal of active games before going to bed, walking in the fresh air.
Let us consider in more detail how to treat a neurogenic bladder with the help of medications. Prescribed drugs of these groups:
- vitamins (in particular, group B, PP, A, E) at doses corresponding to the patient's age;
- anticholinergics (bellataminal 0,5-1 tablet 2 r daily, melipramine 0,02-0,05 g per night, atropine 0,05-0,5 mg 1-2 times a day - one of the drugs selectively);
- means for normalization of metabolic processes in the central nervous system (amino acids, nootropics, sedatives).
The specialist should prescribe the diagnosis and prescribe the treatment, because the choice of treatment tactics depends entirely on the severity of the dysfunction, its type, the general condition of the patient, the effectiveness of the previously used methods of treatment, the presence of concomitant diseases,