Overactive and neurogenic bladder.
Overactive bladder is also called urge incontinence. This condition involves a  sudden, strong need for the individual to urinate, caused by a bladder contraction and leading to an involuntary release of urine. The condition is also described as detrusor instability, hyper-reflexive or hyperreflexia and irritable, spasmodic or spastic bladder.
If the condition occurs due to damage of the relevant nerves, is called neurogenic bladder. The latest can be overactive and under-active or hypo-tonic bladder. The under-active type of neurogenic bladder is characterized by massive capacity, which in some cases may gradually reach the 2,000ml and it is accompanied by extremely reduced or absolute absence of sensation of the fullness. Eventually, an involuntary loss of urine happens, as soon as the pressure within the bladder reaches the burst point.
Overactive bladder may affect badly a person's quality of live and apparently, may result in lower self-confidence and self-esteem and occasionally in depression.
Causes and incidence of neurogenic, overactive bladder.
The process of urination includes two stages; the collection or storage phase, and the emptying phase. A person's ability to retain urine and maintain bladder continence dependents on proper function of the autonomic nervous system, the kidneys and the lower urinary tract, including sphincter and detrusor. The two latest are the muscles which control the function and maintain the stability of the bladder.
In the first phase, the bladder expands by stretching its walls in order to accommodate the increasing amount of urine. The volume of a full bladder of an average person varies between 350ml and 550ml.
As soon as nearly 200ml of urine is collected, the first signal for urination occurs, while bladder keeps on expanding.
The emptying phase requires the simultaneous coordination of the detrusor muscle for adequate contraction and the sphincter to allow the urine to exit the bladder. Dysfunction of any of these two muscles or failure of the relevant part of autonomic system that innervates them can result in sudden and too frequent need for urination, urine leaking or inadequate discharge of urine.
Urge incontinence and neurogenic bladder can be caused by neurological injuries, by diseases or by a number of localized medical conditions. These include surgical or accidental spinal cord injury, multiple sclerosis, diabetes and stroke. Localized factors may be bladder problems, such as infections or inflammations, cancer, kidney stones and outlet obstruction at the base of the bladder.
Urge incontinence and neurogenic bladder may occur in anyone at any age. However, it is more common in women, elderly and diabetics. In men, urge incontinence may be caused by enlarged prostate.
Some habits, such as taking bubble baths or using caustic soaps in the genital area, may worsen urge incontinence, since they can irritate both urethra and bladder.
Symptoms of neurogenic, overactive bladder.
These symptoms are urinary urgency, frequent urination, involuntary loss of urine and abdominal distention.
Apart from the above ones, symptoms of neurogenic, overactive bladder include loss of the urge to urinate, when the bladder is full.
Diagnosis of neurogenic, overactive bladder.
A physical examination of the abdomen and rectum or a pelvic check for females and a genital examination for males may be enough for urge incontinence initial diagnosis. However, a number of laboratory tests, x-rays or an evaluation of bladder function (urodynamics) are necessary for verification.
An indication of the presence of the condition may be an angle change by thirty degrees or more. This may be due to stress caused by incontinence.
In time diagnosis is important for efficient treatment of overactive and neurogenic bladder.
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