Disturbance of innervation of the bladder. The bladder does not contract - what to do? Physiology of the hollow organ of the excretory system

The human urinary system, with its multiple nerve endings, is a complex mechanism. An important element in its work is the occurrence of the urge to withdraw urine, the ability of a person to control the restraint and relaxation of muscles. This process is guaranteed by the innervation of the bladder (in other words: its connection with the central nervous system). Special impulses are transmitted through nerve tissues, giving peculiar signals about its filling.

The bladder is a hollow organ located in the pelvis. It serves as a kind of reservoir for the accumulation of urine (urine) produced by the kidneys for the purpose of its further removal from the body.

Thanks to innervation, a person can restrain emptying the bladder for a certain time by force of will. Disruption of the nervous system leads to a malfunction in the well-established urinary system, which can lead to neurogenic syndrome.

Kidney activity is accompanied by systematic filling of the bladder as a result of rhythmic muscle contractions. Its volume on average ranges from 500 ml in women to 700–750 ml in men. The walls of the bladder are capable of expansion, so the presence of up to 150 ml of urine in it is practically not felt by a healthy person.

With further stretching of the walls, pressure on them increases, discomfort and the urge to urinate at the level of reflexes arise. The urge is formed when there is about 300 ml of liquid in the bladder. When the level reaches 700 ml, its release can occur uncontrollably.

The bladder is divided into a body, an apex, a bottom and a neck underneath. Everything is covered with three layers of muscle, as a result of which contraction results in the release of urine. Muscle relaxation or tension occurs during conscious urination during the urge to urinate.

The mechanism for restraining spontaneous urine discharge is provided by the internal and external sphincters, which are in a compressed state. The sphincter is a muscle that helps narrow or completely close the passage, in our case from the bladder to the urethra.

Formation of the urination reflex

Under the influence of nerve impulses, the internal sphincter contracts - the walls of the bladder relax, urination is delayed. Sensitive nerves of the pelvis, transmitting signals about the level of fullness, contribute to the formation of the urge to release urine.

The process of urination consists of several interconnected stages.

1. The bladder fills and the pressure inside it increases.
2. Stretch receptors are activated, transmitting a signal to the spinal cord and then to the brain.
3. The part of the brain responsible for urine discharge sends an impulse towards the bladder to create the urge to urinate.
4. The signal returns via parasympathetic fibers.
5. The muscles contract and urine is released.
6. The pressure returns to normal.

In the absence of urine separation, impulses become more frequent and intensified, which can cause spontaneous urination and various urination disorders. If the central nervous system is affected, urination may become uncontrollable.

Disorders of the innervation of the bladder

There are two main types of disorders: urinary incontinence or, on the contrary, retention of urine. When there is difficulty urinating, urine remains in the urinary organ, and separation does not occur completely.

Relationship between innervation disorders and the activity of the nervous system

The walls of the urinary organ are equipped with a mass of nerve endings. Nerves of the sympathetic, parasympathetic, and spinal types connect the organ with the central nervous system. Stable urinary control is controlled by them. Each of the named types of nerves has its own task.

The vesical plexus, which provides innervation, is composed of different types of nerve cells. Disturbances in any of the departments cause disorders in the control of urine output.

• Parasympathetic innervation. The parasympathetic nodes are located close and in the tissue of the organ itself. The corresponding nerve endings are located in the sacral section of the spinal cord. The fibers make up the pelvic plexus, stimulating smooth muscle contraction. It relaxes the sphincters, facilitating the release of urine.
• Sympathetic innervation. The sympathetic plexuses are located at a distance from the organ. Nerve cells located in the lumbar region (gray column), triangle of the bladder and neck stimulate its closure to allow fluid to accumulate. They have virtually no effect on urine excretion.

The formation of the urge to divert urine is nothing more than a reaction to the pressure of urine on the walls of the bladder and their stretching. This reaction is provided by afferent fibers, the signal through which travels along the nerves to the spinal cord.

Options for innervation disorders

When innervation is disrupted, there is a failure in the regulation of urination, which exists in different variants.

The cause of any of the variants of urinary dysfunction is problems associated with brain damage. Among the pathologies leading to innervation disorders are the following:

• cardiovascular diseases;
• brain injuries;
• brain tumors;
• multiple sclerosis.

External symptoms are not enough to identify pathology. It is important to examine the part of the brain in which the changes occurred.

Features of innervation in various types of diseases:

Disease	What is it characterized by?
Multiple sclerosis	The columns (posterior and lateral) of the cervical spine undergo pathological changes, which is accompanied by involuntary urination with the gradual development of symptoms
Peripheral paralysis	There is a blocking of reflex muscle contractions, leading to disruption of independent relaxation of the external sphincter
Neuropathy	Pathological processes are observed in various parts of the nervous system
Diabetic neuropathy	Pathologies of the muscular lining of the bladder are noted
Cauda equina syndrome	Both delay and fact of urine incontinence are detected
Lumbar spinal stenosis	Damage to the urinary system occurs
Spinal dysraphism	There is an inability to consciously separate urine due to impaired reflexion

With severe brain damage, dysfunction becomes more complex. That's why timely diagnosis and treatment are so important.

Diagnostics

The need for a full study is indicated by the following signals: Changes in the frequency of urination, loss of control over its process.

Comprehensive diagnostics includes studies:

1. X-ray of the skull, spinal column (ultrasound).
2. Ultrasound of the abdominal cavity, kidneys, bladder.
3. MRI (if indicated).
4. Encephalogram.
5. Electromyography (determining the activity of the pelvic muscles).
6. Analyzes of different types of urine and blood.
7. Regulation of urine flow rate (uroflowmetry).
8. Cytoscopy (visual analysis of the organ).

The causes of disturbances in the urination cycle can be tumors, anatomical pathologies, urolithiasis, and psychological problems.

Treatment

Treatment is determined by the nature of the lesion, its degree and happens:

• medicinal;
• surgical;
• non-medicinal.

Innervation is restored in full when using various treatment methods.

1. Therapy to activate all parts of the nervous system using the following means:

• cholinomimetics;
• coenzymes;
• andrenomimetics;
• drugs: Aceclidine, Citrochrome C, Isoptin.

1. A method of electrical stimulation of the urinary system in order to activate the work of the sphincters.
2. The use of antidepressants and tranquilizers to support autonomic regulation.

Urgent hospitalization is required when urine output completely stops. In this case, catheters are used to remove it until it is completely cured. Innervation can be restored in full. During the treatment period, sleep patterns, walks, and gymnastics are important.

The urinary process is closely related to the state of the central nervous system. If nerve impulses are disrupted in one of its sections, innervation of the bladder may occur. It is important to see a doctor, timely diagnosis and therapy. Communication with the central nervous system can be restored in full.

Neural regulation of bladder function allows for alternating long periods of filling and short periods of emptying.

Parasympathetic(stimulating)fibers from the sacral part of the spinal cord (Fig. 27–1) as part of the pelvic nerves are directed to the muscle that pushes urine ( m. detrusor vesicae). Excitation of the nerves leads to contraction of the detrusor and relaxation of the internal sphincter of the bladder.

Sympathetic(delaying)fibers from the lateral nuclei of the lower spinal cord are sent to the inferior mesenteric ganglion. From here the excitation is transmitted along the hypogastric nerves to the muscles of the bladder. Irritation of the nerves causes contraction of the internal sphincter and relaxation of the detrusor, that is, it leads to a delay in urine output.

Sensitive fibers. The pelvic nerves also contain sensory nerve fibers that transmit information about the degree of stretching of the bladder wall. The strongest signals about stretching come from the posterior part of the urethra; they are responsible for the occurrence of reflexemptyingurinarybubble.

Rice. 27–1 . Innervation of the bladder

Somatic motor fibers. The pudendal nerves contain somatic motor fibers that innervate the skeletal muscles of the external sphincter.

Urination reflex

Bladder pressure that reaches a suprathreshold level causes irritation of stretch receptors in the bladder wall, especially receptors in the posterior urethra. Impulses from stretch receptors are carried to the sacral segments of the spinal cord through the pelvic nerves and reflexively return back to the bladder through the parasympathetic nerve fibers of the same pelvic nerves. If the bladder is partially filled, urinary contractions are replaced by relaxation, and the pressure returns to its original level. If the bladder continues to fill with urine, the micturition reflex becomes more frequent and causes progressively greater contractions of the detrusor muscle. The first contraction of the bladder activates stretch receptors, which send even more impulses, and further intensification of the contraction occurs. This cycle is repeated over and over again until a strong degree of contraction is achieved. After a few seconds or more, the bladder relaxes. Thus, the cycle of the urination reflex includes: a rapid increase in pressure, a period of holding pressure, and a return of pressure to its original value.

Voluntary urination begins as follows. The individual voluntarily contracts the abdominal muscles, which increase the pressure in the bladder with the subsequent entry of additional portions of urine into the neck of the bladder and the outer part of the urinary canal, stretching their wall. This stimulates stretch receptors, which stimulate the urethral reflex and simultaneously inhibit the external urethral sphincter. The perineal muscles and external sphincter can contract voluntarily, stopping the movement of urine into the urethra or interrupting urination that has already begun. It is well known that adults are able to keep the external sphincter in a contracted state, and they are, accordingly, able to delay urination caused by necessary circumstances. After urination, women's urethra is emptied by gravity. In men, the urine remaining in the urethra is expelled by several contractions of the bulbospongiosus muscles.

Reflex control. Stretch receptors in the wall of the bladder do not have special regulatory motor innervation. However, the threshold of the voiding reflex, like the stretch reflexes of skeletal muscles, is controlled by the activity of the facilitatory and inhibitory centers of the brain stem. Facilitating areas are localized in the area of ​​the pons and posterior hypothalamus, inhibitory areas are located in the area of ​​the midbrain and superior frontal gyrus.

Of great practical importance is the identification of dysfunctions of the bladder, which arise in connection with a disorder of its innervation, which is provided mainly by the autonomic nervous system (Fig. 13.4). Afferent somatosensory fibers originate from the proprioceptors of the bladder, which respond to its stretching. The nerve impulses arising in these receptors penetrate through the spinal nerves S„-SIV Fig. 13.4. Innervation of the bladder (according to Müller). 1 - paracentral lobule; 2 - hypothalamus; 3 - upper lumbar spinal cord; 4 - lower sacral spinal cord; 5 - bladder; 6 - genital nerve; 7 - hypogastric nerve; 8 - pelvic nerve; 9 - plexus of the bladder; 10 - detrusor of the bladder; 11 - internal sphincter of the bladder; 12 - external sphincter of the bladder. into the posterior cords of the spinal cord, subsequently enter the reticular formation of the brain stem and further into the paracentral lobules of the large hemispheres, while along the way, some of these impulses pass to the opposite side. Thanks to the information going along the indicated peripheral, spinal and cerebral structures to the paracentral lobules, the stretching of the bladder when it fills is realized, and the presence of incomplete crossover of these afferent pathways leads to the fact that, with the cortical localization of the pathological focus, a violation of control over pelvic functions usually occur only when both paracentral lobes are affected (for example, with falx meningioma). Efferent innervation of the bladder is carried out mainly due to the paracentral lobules, the reticular formation of the brain stem and spinal autonomic centers: sympathetic (neurons of the lateral horns of the Th11-L2 segments) and parasympathetic, located at the level of the spinal cord segments S2-S4. Conscious regulation of urination is carried out mainly due to nerve impulses coming from the motor zone of the cerebral cortex and the reticular formation of the trunk to the motor neurons of the anterior horns of the S3-S4 segments. It is clear that to ensure nervous regulation of the bladder, the preservation of the pathways connecting these structures of the brain and spinal cord with each other, as well as the formations of the peripheral nervous system that provide innervation to the bladder, is necessary. Preganglionic fibers coming from the lumbar sympathetic center of the pelvic organs (L1-L2) pass as part of the presacral and hypogastric nerves in transit through the caudal sections of the sympathetic paravertebral trunks and along the lumbar splanchnic nerves (pi. splanchnici lumbales) reach the nodes of the inferior mesenteric plexus (plexus mesentericus inferior). Postganglionic fibers coming from these nodes take part in the formation of the nerve plexuses of the bladder and provide innervation primarily to its internal sphincter. Due to sympathetic stimulation of the bladder, the internal sphincter, formed by smooth muscles, contracts; in this case, as the bladder fills, the muscle of its wall stretches - the muscle that pushes urine out (i.e. detrusor vesicae). All this ensures urine retention, which is facilitated by the simultaneous contraction of the external striated sphincter of the bladder, which has somatic innervation. It is carried out by the pudendal nerves (p. pudendi), consisting of axons of motor neurons located in the anterior horns of the S3-S4 segments of the spinal cord. Efferent impulses to the pelvic floor muscles and counter proprioceptive afferent signals from these muscles also pass through the pudendal nerves. Parasympathetic innervation of the pelvic organs is carried out by preganglionic fibers coming from the parasympathetic center of the bladder, located in the sacral part of the spinal cord (S1-S3). They participate in the formation of the pelvic plexus and reach the intramural (located in the wall of the bladder) ganglia. Parasympathetic stimulation causes contraction of the smooth muscle that forms the body of the bladder (i.e. detrusor vesicae), and a concomitant relaxation of its smooth sphincters, as well as increased intestinal motility, which creates conditions for emptying the bladder. Involuntary spontaneous or provoked contraction of the detrusor bladder (detrusor overactivity) leads to urinary incontinence. Detrusor overactivity can be neurogenic (for example, in multiple sclerosis) or idiopathic (in the absence of an identified cause). Urinary retention (retentio urinae) most often occurs due to damage to the spinal cord above the location of the spinal sympathetic autonomic centers (Th10-L2), responsible for the innervation of the bladder. Urinary retention is caused by dyssynergia of the detrusor and bladder sphincters (contraction of the internal sphincter and relaxation of the detrusor). This happens, for example, with traumatic damage to the spinal cord, intravertebral tumor, multiple sclerosis. In such cases, the bladder becomes full and its bottom can rise to the level of the navel and above. Urinary retention is also possible due to damage to the parasympathetic reflex arc, which closes in the sacral segments of the spinal cord and provides innervation to the detrusor of the bladder. The cause of paresis or paralysis of the detrusor can be either a lesion of the specified level of the spinal cord or a disorder of the function of the structures of the peripheral nervous system that make up the reflex arc. In cases of persistent urinary retention, patients usually need to empty the bladder through a catheter. Along with urinary retention, neuropathic fecal retention (retencia alvi) usually occurs. Partial damage to the spinal cord above the level of the autonomic spinal centers responsible for the innervation of the bladder can lead to disruption of voluntary control of urination and the emergence of the so-called imperative urge to urinate, in which the patient, feeling the urge, is unable to hold urine. A major role is likely to be a disturbance in the innervation of the external sphincter of the bladder, which normally can be controlled to a certain extent by willpower. Such manifestations of dysfunction of the bladder functions are possible, in particular with bilateral damage to the medial structures of the lateral cords in patients with an intramedullary tumor or multiple sclerosis. A pathological process that affects the spinal cord at the level of the location of the sympathetic autonomic centers of the bladder (cells of the lateral horns of the Th1-L2 segments of the spinal cord) leads to paralysis of the internal sphincter of the bladder, while the tone of its protrusor is increased, in In connection with this, there is a constant release of urine in drops - true urinary incontinence (incontinentia urinae vera) as it is produced by the kidneys, while the bladder is practically empty. True urinary incontinence may be caused by spinal stroke, spinal cord injury, or spinal tumor at the level of these lumbar segments. True urinary incontinence can also be associated with damage to the structures of the peripheral nervous system involved in the innervation of the bladder, in particular with diabetes mellitus or primary amyloidosis. When urine retention occurs due to damage to the structures of the central or peripheral nervous system, it accumulates in the overstretched bladder and can create such high pressure in it that under its influence the internal and external sphincters of the bladder, which are in a state of spastic contraction, are stretched, In this regard, urine is constantly released through the urethra in drops or periodically in small portions while the bladder remains full - paradoxical urinary incontinence (incontinentia urinae paradoxa), which can be detected by visual examination, as well as by palpation and percussion of the lower abdomen, standing the bottom of the bladder above the pubis (sometimes up to the navel). If the parasympathetic spinal center (segments of the spinal cord S1-S3) and the corresponding roots of the cauda equina are damaged, weakness may develop and a simultaneous disturbance in the sensitivity of the muscle that pushes out urine (i.e. detrusor vesicae), and urinary retention occurs. However, in such cases, over time, it is possible to restore reflex emptying of the bladder; it begins to function in an “autonomous” mode (autonomous bladder). Clarifying the nature of bladder dysfunction can help determine the topical and nosological diagnoses of the underlying disease. In order to clarify the characteristics of bladder function disorders, along with a thorough neurological examination, if indicated, radiography of the upper urinary tract, bladder and urethra is performed using radiopaque solutions. The results of urological examinations, in particular cystoscopy and cystometry (determining the pressure in the bladder during filling with liquid or gas), can help clarify the diagnosis. In some cases, electromyography of the periurethral striated muscles may be informative.

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The bladder is described as a muscular organ with an elastic and extensible membrane of the walls, having free, empty space inside. It is located in the lower abdomen and serves as a reservoir for urine accumulation.

Urine is excreted by the body from the kidneys through the ureters. Emptying occurs when a certain pressure is applied to the bladder. In fact, this is the nerve ending that lets you know about the need for emptying. Urine exits through the urethra.

The shape of a hollow muscular organ is directly related to the phenomena and needs occurring in the body. It can change when filled with urine, when emptied of waste products, due to the location of nearby organs.

The innervation of the bladder plays an important role in the functioning of the organ itself. If any disturbances occur, the patient may feel an increased or decreased number of incentive reactions in the sac-like organ. Any deviations from the intended functioning of the bladder can cause a number of ailments and illnesses.

Diseases provoked by the innervation of an organ in a state filled and empty of urine

Excess of innervation leads to a neurogenic bladder. This disease indicates the beginning of incorrect functioning of the urinary canals. Urinary tract problems can be acquired during life or can be a congenital disorder related to the nerves.

The connection between the bladder and the nervous system is very important for a person to live a full life. When the disease occurs, the patient’s urinary canals atrophy, or they work too actively. Such disorders can manifest themselves with injuries or parallel diseases (pathologies of the anterior part of the central nervous system, multiple sclerosis, stroke, parkinsonism, Alzheimer's disease, spinal cord lesions). The patient completely loses control over the process of removing urine from the body.

In turn, the neurogenicity of the muscular organ is divided into hyperactive and hypoactive types of disease development.

Hyperactive appearance of the neurogenic organ for storing and excreting urine

This type of development of neurogenic bladder malaise entails impaired functioning of the part of the nervous system that is located above the bridge of the anterior part of the central nervous system. In this case, the tension in the muscles of the urinary system becomes more intense.

Doctors diagnose such phenomena as detrusor hyperreflexia. This type of excess of the innervation of the sac-like organ leads to uncontrolled urination; involuntary release of urine can begin at any inopportune moment. The disease causes severe social and psychological discomfort to a person.

When a patient has an overactive detrusor, urine does not accumulate in the hollow organ, so he is forced to visit the restroom many times.

Hypoactive type of neurogenic muscle bladder

This type of disease begins its development under the pons of the brain, in most cases the lesion occurs in the sacral region. Such defectiveness of the nervous system leads to incomplete contractions of the lower urinary excretory muscles or a complete absence of the necessary contractions. Doctors diagnose this course of the disease as detrusor areflexia.

Patients are simply not physiologically able to go to the toilet normally when the organ is full. They lose the sensitivity of the emptiness of the muscular organ, suffering from pain in the urethra. Some people do not feel the urge to urinate and cannot control the orbicularis muscle, which serves to narrow or close the urinary duct.

Complications of the innervation of the saccular bladder

Innervation of the bladder in any of its manifestations negatively affects human health and can lead to trophic disorders. If the functioning of the sac-like organ with nerves is abnormal, the blood supply to the urinary organs is disrupted.

In addition to the whole bouquet of unpleasant sensations, cystitis may also begin to bother you, which can transform into microcystitis. Microcystitis leads to a decrease in bladder size due to chronic inflammation. Microcystitis has a rather strong and negative effect on all bladder functions. This disease is characterized as the most dangerous among chronic cystitis and neurogenic bladder.

Residues of urine increase the risk of developing infections in the organ and inflammation throughout the canal. Typically, neurogenic bladder disease complicated by cystitis is resolved with surgical methods.

Diagnosis and timely therapy

The patient must undergo general blood and urine tests to identify a possible inflammatory process. You should also undergo a number of procedures for a comprehensive examination of the urinary tract, such as: ultrasound, urethrocytography, cytoscopy, urography, MRI if necessary and others.

To investigate neurological abnormalities, you may be prescribed an EEG, MRI, or examination using other methods. Neurogenic bladder disease is often cured. The main thing is to contact a specialist in time. As for medications, you may be prescribed medications that improve blood circulation, antibiotics, adrenergic blockers, and anticholinergics.

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Urination is a complex reflex act, manifested by the urge to urinate. The smooth operation of this mechanism is carried out by the innervation of the bladder. What is innervation? What are the possible violations of this process? What can you do?

To remove urine, the bladder is equipped with circular muscles - sphincters, detrusor- muscle layer on the walls. By contracting, they contribute to this process. A certain role is played by the striated muscles of the perineum, genitourinary diaphragm, and abdominal muscles.

Urination is considered a voluntary reflex act under the control of the central nervous system. When an organ is filled to certain limits, tension receptors located in its walls send a signal to the central nervous system along centripetal fibers. That, in turn, sends a signal along the centrifugal nerves that causes the urge to urinate.

The process of emptying begins with relaxation of the sphincter and contraction of the detrusor. These actions create a stream or stream of urine.

Responsible for all these functions innervation - supply of organs and tissues with nerves. It communicates between the urinary system and the central nervous system.

What is a violation of the innervation of the bladder?

Distinguish afferent(sensory) innervation and efferent(motor). Thanks to the connection that exists between the urinary organ and the central nervous system, the latter constantly controls and changes the activity of the organ itself and its tissues, taking into account the needs of the body. If this connection, for some reason, works with interference or breaks down altogether, then we can say that the innervation is disrupted.

Classification

The connection between the urinary system and the central nervous system is carried out through parasympathetic, sympathetic, and sensory fibers. The slightest interruptions in these areas lead to various disorders.

Parasympathetic center(excitatory fibers), located in the sacral part of the spinal cord, is involved in the innervation of the pelvic organs. Responsible for relaxing the sphincter muscles and releasing urine.

Sympathetic center(vegetative), located in the intermediate lateral column of the lumbar spinal cord, stimulates the closure of the cervix and the retention of urine in the bladder cavity.

Sensory nerves located in the posterior part of the urethral canal, stretch the walls of the bladder and are responsible for the appearance of a reflex to empty its cavity.

Distortion of the nervous regulation of urination leads to disruptions in the innervation of the organ.

Hyperreflex bubble

Urine is not collected to the required volume. The person experiences an increased urge to urinate. At the same time, the amount of urine excreted is very minimal. This violation indicates problems in the central nervous system.

Hyporeflex bubble

Urine accumulates above normal (up to 1.5 liters). A person experiences difficulty urinating and emptying the organ. This entails inflammatory and infectious diseases of the entire urinary system. This disorder indicates problems in the sacral part of the brain.

Areflex bubble

Urine that has accumulated to the required volume begins to spontaneously flow out. A person is not able to control this process.

Since all these disorders are nervous, the term “neurogenic bladder” is used in medicine.

Causes and symptoms of changes

All types of violations have different causes. The most common: traumatic brain injuries. cardiovascular diseases. tumors.

1. Cauda equina syndrome. Causes incontinence due to overflow of the urinary organ or interruption of excretion.
2. Diabetic neuropathy. Causes dysfunction in pushing urine out of the organ cavity. A narrowing (stenosis) occurs in the lumbar spine. The urinary system is disrupted.
3. Peripheral paralysis. Muscles cannot contract reflexively. The lower sphincter does not relax on its own.
4. Supraspinal disorders of the motor systems of the brain. The reflex function of urination is affected. Enuresis develops, frequent urges even at night. The functionality of the underlying muscles is preserved, blood pressure is normal, and there is no threat of urological diseases.
5. Multiple sclerosis- disrupts the functions of the lateral, posterior columns of the cervical spinal cord, which leads to areflexivity. Symptoms develop gradually.

Diagnostics

To make an accurate diagnosis, the patient needs to consult a urologist and neurologist. The doctor will interview the patient and suggest the following methods:

• For several days, keep a log of time, volume of liquid drunk and urination.
• Submit bacterial culture and OAM for infections.
• Get an X-ray with a contrast agent, MRI, ultrasound to exclude tumors and inflammatory processes.
• To exclude pathological changes in the brain and spinal cord - CT, MRI.
• Additionally - uroflowmetry and cystoscopy.

If this diagnosis does not allow the cause to be determined, a diagnosis is made - a neurogenic bladder of unknown origin.

Treatment

In this case, drug, non-drug treatment is used. To restore the reflex function of the sphincters and their activity with the detrusor, electrical stimulation of the muscles of the bladder, groin, and anal sphincter is prescribed.

To restore and activate the efferent parts of the ANS, calcium ion antagonists, adrenomimetics, coenzymes, and cholinomimetics are prescribed. Commonly used: Aceclidine, Ephedrine hydrochloride, Cytochrome C, Isoptin.

To maintain and restore the regulation of the ANS, the doctor individually selects tranquilizers and antidepressants.

In exceptional cases, it is prescribed surgery. Based on the reasons, adjustments can be made to the nervous system of the organ or plasticity of the muscular-ligamentous apparatus.

Disturbance of bladder innervation is a common phenomenon. It is important to take steps to eliminate the problem at the first symptoms.