did you know that having a condition
that affects your brain or spinal cord
can actually affect the way your bladder
functions I'm Dr Rena Malek urologist
and pelvic surgeon and today I'm going
to talk about neurogenic bladder or
essentially problems that affect the
bladder due to neurologic conditions
such as spinal cord injuries Strokes
diabetes and multiple sclerosis
Parkinson's disease and a whole host
more I'm going to give you a general
overview and if you want to learn more
about any of those conditions please
comment down below and let me know so to
start off when you think of the body
essentially parts of the brain the
spinal cord all send nerves and signals
to the bladder and when there's any
disruption in either the brain the
spinal cord or the nerves that go to the
bladder it can cause problems with the
way the bladder functions when we think
about problems with the bladder there's
two ways to think about it so here's our
bladder it has two ureters right here
which are the tubes that drain the
bladder as well as the bladder itself
and then the outlet or the urethra or P
tube where the urine comes from this is
obviously a female urethra because the
male urethra is much longer however you
could think about it as a problem with
the bladder or a problem with how the
urine empties or what we call the outlet
of urine you can have problems with the
bladder itself where either it doesn't
store urine well meaning that urine is
leaking out because the bladder is not
able to hold urine well or there's a
problem with failure to empty meaning
that the bladder is not squeezing to
empty the bladder itself you can also
have these same problems but because of
the outlet it can be that the sphincter
which is inside the urethra that usually
helps keep urine in when your bladder is
filling and relaxes when your bladder is
peeing is not functioning appropriately
or it's very weak or it can be failure
to empty meaning the sphincter doesn't
relax when it should so like I said when
you're peeing the sphincter relaxes and
it allows urine to empty out and it
really depends on what kind of injury
you have it what problem problem will
happen will it affect the bladder or the
outlet I'm going to go over some of the
most common conditions and what we often
see as problems with these conditions
first type of neurologic conditions we
think of are those that affect the brain
that can be things like stroke can be
things like Parkinson's disease and can
be things like trauma to the brain if
you've had a brain injury or even
Dementia in these patients how I
describe it to them is that typically
our brain has a break the break is on
the bladder so the bladder can fill and
not contract and when the bladder is
full it sends signals to the brain the
break comes off the bladder squeezes and
it empties but the break is broken
because there's problem with the brain
and so now the bladder essentially
squeezes before it's full giving you
this constant urge to urinate so you
gotta gotta go Gotta Go you can't make
it to the bathroom and often you're
having leakage also patients will
experience frequency like need to go to
the bathroom very often and sometimes
even at night the next category of
conditions is called spinal cord
injuries and spinal cord injuries it
really depends where they are in this
spinal cord are they in the top part of
the spinal cord what we call suprasacral
or are they at the very low part of the
spinal cord where they're infrasacral in
those who have supersacral injuries we
see patients who have issues with not
only that bladder problem where they're
going very often because their bladder
is squeezing before it's ready but we
also have a problem with the sphincter
the sphincter is often not relaxing in
time when you need to empty so they'll
feel a lot of urge to go but then they
can't empty because the sphincter
doesn't relax it's not coordinated with
the brain and so this creates a lot of
problem and in fact is quite dangerous
because what happens is you're getting
all this pressure from the bladder
squeezing and your sphincter is not
opening so where does that pressure go
well if you remember how the bladder is
it's going to go up these tubes up the
ureters and they're attached to the
kidneys up here and so that can create
long-term problems so if you have a
spinal Court injury or something like
multiple sclerosis which can also
present like this very similarly and
you're having trouble emptying your
bladder it's very important to see a
urologist and get regular follow-up to
make sure your kidneys are safe and
lastly sacral spinal cord injuries these
often present with bladders that
actually don't contract at all so these
bladders essentially don't work at all
they're just expand expand expand like a
balloon and they never contract so you
can't actually empty the urine very well
sometimes people who have this problem
particularly actually diabetics often
can develop this problem after many many
years of having diabetes can overcome it
because they can bear down just like
you're having a bowel movement or having
a poop when you push you can sometimes
empty urine that way but these people
can also have a sphincter that doesn't
work so now they have a bunch of urine
and a sphincter that doesn't relax
that's fixed and then you're having
trouble emptying your bladder and again
these people need to see a urologist
regularly to get checked because again
you can have that same problem where the
urine fills and fills and fills backs up
to the ureters and causes problems with
the kidney also many people who have
these issues can also get recurrent
urinary tract infections if you want to
learn more about how to prevent
recurrent urinary tract infections check
out my video on that as well but this is
a real problem and a huge quality of
life issue all this to say is that
depending on what you have you may or
may not follow the textbook but
certainly these can have serious
implications for your bladder function
and it's really important to see a
urologist to discuss what type of
neurogenic bladder you might have and
how you can fix it and live a better
quality of life prevent infections and
prevent problems to your kidneys hope
you guys found this helpful as always
remember take care of yourself because
you're worth it
foreign
[Music]