Traditional medicine

Disturbance of innervation of the bladder. Treatment of neurogenic bladder: specialists in German clinics Chronic phase of spinal disorders

If the reason urinary disorders serves as a brain disease, a violation of the inhibitory influences of the cortex occurs and involuntary emptying of the bladder occurs with varying frequency. The volume of urine in this case is greater than with a reflex spinal bladder (automatic bladder); residual urine is not detected. This form of urinary dysfunction is rare and is observed mainly in patients with severe senile dementia. Its symptom is also a psychoorganic syndrome, which may be accompanied by epileptic seizures, neuropsychiatric disorders or focal neurological symptoms.

Characteristic manifestations of urinary incontinence are also observed in aresorptive hydrocephalus.
If observed pronounced syndrome transverse lesion of the spinal cord, it is this, and not the urination disorder, that is leading in the clinical picture.

Discrete signs of transverse lesion and urinary disorder.
Latest correspond in this case to the automatic bladder, i.e. frequent urination is observed (which can be provoked, for example, by patting the lower abdomen) with involuntary release of a relatively small volume of urine. It is necessary to identify signs of spastic paresis, pyramidal signs and the level of sensory impairment. Among the reasons worth mentioning:
compression of the spinal cord due to a volumetric intraspinal process;
myelitis;
multiple sclerosis.

Multiple sclerosis especially often accompanied by an urgent urge to urinate, which is sometimes an early symptom of the disease. They serve as a sign of a supranuclear disorder: when the urge appears, the patient must immediately run to the toilet, otherwise involuntary urination occurs. Such patients have to plan their daily life in such a way that they are always close to the toilet. It is always necessary to ask the patient in detail about such disorders; they are very characteristic of multiple sclerosis, but occasionally they can also be functional in nature.

In these cases urinary disorder accompanied by sensory disturbances and/or paresis. The main sign is that the patient does not feel the passage of urine when emptying the bladder and feces through the rectum (about which he should be questioned in detail). There is also a violation of sensitivity in a sitting position (saddle anesthesia) and during sexual intercourse. A neurological examination of the patient should include a study of sensitivity in the anogenital area, identification of motor disorders in the area of innervation of the sacral roots, as well as assessment of the anal and bulbocavernous reflexes. Urinary dysfunction is characterized by an overfilled bladder with a large volume of residual urine. The main causes are a space-occupying process in the lumbosacral spinal canal and tethered cord syndrome.

In relatively acute the appearance of urinary disorders accompanied by pain in the sacrum and sciatica, suspicion arises:
for a herniated disc at the lumbar level, especially the median;
rapidly progressing intraspinal tumor (malignant tumor or metastases) at the lumbosacral level, as well as carcinomatous meningosis;
root damage due to borreliosis.

If the disorder develops quickly, but not accompanied by pain, we can assume:
volumetric process of the horse's tail itself
or an inflammatory process in this area (for example, Ellsberg syndrome).

Polyradiculoneuritis(Guillain-Barré syndrome) is not accompanied by urination problems.

Urinary dysfunction increases gradually.
If violations progress over several months or even years and are accompanied by signs of damage to the roots of the cauda equina; the cause may primarily be a slowly developing space-occupying process in the lumbar spinal canal, for example, dermoid, ependymoma, neuroma, etc. (characterized by an increase in protein content in the cerebrospinal fluid, expansion of the canal during X-ray examination, the decisive methods are CT, MRI, myelography).

If observed signs of impairment, for example, secretion of sweat glands, pyloric reactions, regulation of blood pressure, heart rate or potency, they may be accompanied by autonomic denervation of the bladder, its enlargement, stretching, and flaccid walls. The reasons can be two groups of violations:

Chronic polyneuropathy, especially with diabetes mellitus and primary amyloidosis;
some diseases with predominant damage to the autonomic nervous system, for example, pandysautonomia, Reilly family dysautonomia, orthostatic hypotension in Shy-Drager syndrome, and other multisystem atrophies.

Neurogenic bladder is a dysfunction of urination caused by damage to the nervous system. Neurogenic bladder dysfunction cannot be considered as an independent disease. This is a collective syndrome that combines conditions that arise in connection with congenital or acquired lesions at various levels of the nerve pathways and centers that innervate the bladder and provide the function of voluntary urination.

Causes of neurogenic bladder:

· Inflammatory-degenerative diseases and tumors of the brain and spinal cord (encephalitis; diabetic, alcoholic and post-vaccination neuropathies, cholesteatoma, tuberculoma, multiple sclerosis, etc.).

· Traumatic injuries to the brain and spinal cord (stroke, ruptures, compression, destruction, surgical interventions on the pelvic organs).

· Congenital defects of the terminal spine, spinal cord, and nervous system of the bladder.

Clinic

Disturbances with a neurogenic bladder occur either in the form of pathological urinary retention or in the form of incontinence. True urinary incontinence is accompanied by a lack of sensation of bladder filling. The patient cannot hold urine; it does not accumulate in the bladder and is continuously released drop by drop as it enters it.

With paradoxical urinary incontinence (sluggish bladder), reflex emptying of the bladder is impaired. The detrusor does not contract and the internal sphincter is closed. The bladder fills, but the reflex does not work. When the bladder is full, urine flows out in small portions due to mechanical stretching of the internal sphincter. In this case, a large amount of urine remains in the bladder (residual urine).

In the absence of cortical regulation of urination (in case of damage to the spinal cord above the centers of segmental innervation of the bladder), the bladder is emptied reflexively - automaticity of the bladder is formed: as it stretches with accumulated urine, corresponding irritations of stretch (pressure) receptors arise and reflex emptying occurs. Urine is released involuntarily. The feeling of bladder filling and the urge to urinate are most often absent. In this case, there is periodic urinary incontinence with constant residual urine in the bladder (spastic bladder).

Another disturbance in bladder sensitivity may be a lack of feeling of fullness and the urge to urinate. With this disorder, a person does not feel his bladder and has to constantly remember the need to urinate. This disorder, especially in combination with sphincter spasm, can lead to pathological expansion of the bladder, reflux of urine into the ureters and kidneys with the development of inflammation in them.

Along with the inability to control urination, pathological sensations in the bladder may occur, such as a feeling of excessive fullness with the so-called false urge to urinate. False urges can occur very often, depriving a person of the opportunity to work and communicate normally.

Due to the fact that denervation of the bladder leads to pronounced trophic disorders, the course of the disease is often complicated by interstitial cystitis, which causes sclerosis and shrinkage of the bladder. This severe complication increases the risk to the kidneys and in some cases requires special surgical interventions to increase bladder capacity.

Diagnostics

In addition to examination, great importance is attached to laboratory and instrumental studies in the diagnosis of a neurogenic bladder. Laboratory diagnostics includes a general urine test, a Zimnitsky test, a general blood test, and a biochemical blood test. Radiological studies include survey radiography, urethrocystography (regular and voiding), excretory urography, and ascending pyelography. Significant methods of instrumental diagnostics are ultrasound of the kidneys and bladder, radioisotope renography, cystoscopy, urodynamic study and video-urodynamic study (uroflowmetry, cystometry, sphincterometry).

Treatment

Treatment of neurogenic bladder directly depends on the cause of nerve damage and requires, first of all, treatment of the primary disease. There are three main areas of treatment: medication, electrical stimulation and surgery.

The main type of treatment is the use of pharmacological agents. If urinary retention occurs, adequate drainage of the bladder using an indwelling catheter is also necessary; prevention of urinary tract infection or treatment of urological infection if it develops with antiseptics and/or antibiotics. In patients with urinary incontinence, measures are taken to resume reflex emptying of the bladder. For this purpose, regular clamping of the permanent catheter every 2-3 hours and other methods are used.

You can undergo diagnosis and treatment of the disease in the neurology department of the Spinal Cord Pathology Center of our clinic.

An important link in the process of urination is the occurrence of the urge to defecate. The operation of this mechanism is ensured by the innervation of the bladder - numerous nerve endings of the organ promptly send signals necessary for the body. Disruption of the nervous system can also lead to dysfunction of bowel movements. You can understand the relationship between structures by considering the mechanism of urine secretion.

Urinary excretion algorithm

The average bladder volume is 500 ml. Slightly more for men (up to 750 ml). In women, as a rule, it does not exceed 550 ml. The continuous functioning of the kidneys ensures that the organ is periodically filled with urine. Its ability to stretch the walls allows urine to fill the organ up to 150 ml without causing discomfort. When the walls begin to stretch and pressure on the organ increases (usually this occurs when urine volume exceeds 150 ml), a person feels the urge to defecate.

The reaction to irritation occurs at the reflex level. At the point of contact between the urethra and the bladder there is an internal sphincter, and a little lower there is another one - the external one. In the normal state, these muscles are compressed and prevent the involuntary release of urine. When there is a urge to get rid of urine, the valves relax, which ensures contraction of the muscles of the urine-accumulating organ. This is how the bladder is emptied.

Bladder innervation model

The connection between the urinary organ and the central nervous system is ensured by the presence of sympathetic, parasympathetic, and spinal nerves. Its walls are supplied with a large number of receptor nerve endings, scattered neurons of the autonomic nervous system and nerve ganglia. Their functionality is the basis for stable, controlled urination. Each type of fiber performs a specific task. Innervation disorders lead to various disorders.

Parasympathetic innervation

The parasympathetic center of the bladder is located in the sacral part of the spinal cord. Preganglionic fibers originate from there. They take part in the innervation of the pelvic organs, in particular, they form the pelvic plexus. The fibers stimulate the ganglia located in the walls of the urinary system organ, after which its smooth muscle contracts, accordingly, the sphincters relax, and intestinal motility increases. This ensures emptying.

Sympathetic innervation

The cells of the autonomic nervous system involved in urination are located in the intermediate lateral gray column of the lumbar spinal cord. Their main purpose is to stimulate the closure of the cervix, due to which fluid accumulates in the bladder. It is for this purpose that sympathetic nerve endings are concentrated in large numbers in the triangle of the bladder and the neck. These nerve fibers have virtually no effect on motor activity, that is, the process of urine leaving the body.

The role of sensory nerves

The reaction to stretching of the walls of the bladder, in other words, the emergence of a desire to defecate, is possible thanks to afferent fibers. They originate in the proprioceptors and noniceceptors of the organ wall. The signal through them goes to the spinal cord segments T10-L2 and S2-4 through the pelvic, pudendal and hypoastral nerves. This is how the brain receives an impulse to empty the bladder.

Disturbance of the nervous regulation of urination

Violation of the innervation of the bladder is possible in 3 variants:

Hyper-reflex bladder - urine stops accumulating and is immediately released, which is why the urge to go to the toilet is frequent, and the volume of fluid released is very small. The disease is a consequence of damage to the central nervous system.
Hyporeflex bladder. Urine accumulates in large quantities, but its exit from the body is difficult. The bladder is significantly full (up to one and a half liters of fluid can collect in it), inflammatory and infectious processes in the kidneys are possible against the background of the disease. Hyporeflexia is determined by lesions of the sacral part of the brain.
Reflex bladder, in which the patient does not influence urination. It occurs on its own at the moment of maximum filling of the bubble.

Such deviations are determined by various reasons, among which the most common are: traumatic brain injuries, cardiovascular diseases, brain tumors, multiple sclerosis. Identifying pathology based only on external symptoms is quite problematic. The form of the disease directly depends on the fragment of the brain that has undergone negative changes. To denote the dysfunction of the urine reservoir due to nervous disorders, the term “neurogenic bladder” has been introduced in medicine. Different types of nerve fiber lesions impair the excretion of urine from the body in different ways. The main ones are discussed below.

Brain lesions that disrupt innervation

Multiple sclerosis affects the lateral and posterior columns of the cervical spinal cord. More than half of patients experience involuntary urination. Symptoms develop gradually. Sequestration of the intervertebral hernia at the initial stage causes a delay in urine output and difficulty in emptying. This is followed by symptoms of irritation.

Supraspinal lesions of the motor systems of the brain disable the urination reflex itself. Symptoms include urinary incontinence, frequent urges and nocturnal bowel movements. However, due to the preservation of coordination of the work of the basic muscles of the bladder, the required level of pressure is maintained in it, which eliminates the occurrence of urological ailments.

Peripheral paralysis also blocks reflex muscle contractions, causing the inability to independently relax the lower sphincter. Diabetic neuropathy causes problems with the detrusor function of the bladder. Lumbar spinal stenosis affects the urinary system according to the type and level of the destructive process. With cauda equina syndrome, incontinence due to overfilling of the hollow muscular organ and delayed urine output are possible. Latent spinal dysraphism causes impaired bladder reflexion, in which conscious bowel movement is impossible. The process occurs independently at the moment of maximum filling of the organ with urine.

Variants of dysfunction in severe brain damage

Complete spinal cord interruption syndrome is manifested by the following consequences for the urinary system:

In the case of dysfunction of the suprasacral segments of the spinal cord, which can be caused by tumors, inflammation or trauma, the mechanism of damage is as follows. Development begins with detrusor hyperreflexia, followed by involuntary contractions of the bladder and sphincter muscles. As a result, the intravesical pressure is very high and the volume of urine output is very small.
When the sacral segments of the spinal cord are damaged due to injury or disc herniation, on the contrary, there is a decrease in the frequency of bowel movements and a delay in the release of urine. A person loses the ability to independently control the process. Involuntary leakage of urine occurs due to bladder overflow.

Diagnosis and treatment of the disease

The first signal for examination is changes in the frequency of bowel movements. In addition, the patient loses control over the process. Diagnosis of the disease is carried out only in combination: the patient is given an X-ray of the spine and skull, abdominal cavity, they may be prescribed magnetic resonance imaging, ultrasound of the bladder and kidneys, general and bacteriological tests of blood and urine, uroflowmetry (recording the speed of urine flow during normal urination), cytoscopy (examination of the inner surface of the affected organ).

There are 4 methods that help restore the innervation of the bladder:

Electrical stimulation of the urine collector, groin muscles and anal sphincter. The goal is to activate the reflexion of the sphincters and restore their common activity with the detrusor.
The use of coenzymes, adrenomimetics, cholinomimetics and calcium ion antagonists to activate the efferent parts of the autonomic nervous system. Drugs indicated for use: “Isoptin”, “Ephedrine hydrochloride”, “Aceclidine”, “Cytochrome C”.
Tranquilizers and antidepressants restore and maintain autonomic regulation.
Calcium ion antagonists, anticholinergic, anticholinergic drugs, a-andrenostimulants restore the patient’s ability to control urine output, normalize urine retention in the bladder, and regulate the smooth functioning of the sphincter and detrusor. Atropine sulfate, Nifedipine, Pilocarpine are prescribed.

Innervation to the bladder can be restored. Treatment depends on the extent and nature of the lesion and can be medicinal, non-medicinal and surgical. It is extremely important to maintain a sleep schedule, regularly walk in the fresh air, and perform a set of exercises recommended by doctors. It is impossible to restore innervation using folk remedies at home. In order for the disease to be treatable, it is necessary to follow all the prescriptions of the attending physician.

The presence of residual fluid in the bladder after urination is considered a sign of diseases of the genitourinary system.

If the patient does not completely empty the bladder, he or she experiences a number of symptoms that significantly impair the quality of life. In this case, it is very important to quickly establish a diagnosis and begin treatment of the pathology.

In humans, urine is produced in the renal tubules. They receive blood containing waste products. Through the collecting system, urine enters the ureter, from which it passes into the bladder. This organ is necessary to collect fluid and store it for a certain period of time until a sufficiently large portion has accumulated.

There are several types of muscle fibers in the bladder. The longitudinal ones ensure the expulsion of fluid from the organ, the transverse sphincter muscles retain urine in its cavity. At rest, the longitudinal fibers are relaxed and the transverse fibers are contracted.

After the organ is filled, a person has the urge to excrete urine. They begin when 150 ml of fluid accumulates. At this stage, the patient can still hold back urination. After the formation of 200-300 milliliters of urine, the act of excreting it is triggered reflexively.

In the presence of a full bladder, the sphincter suddenly relaxes and the exit to the urethra opens. At the same time, the longitudinal fibers contract, facilitating the release of the entire volume of fluid accumulated in the cavity of the organ.

Disruption of the coordinated work of muscles can lead to the fact that the bladder is not completely emptied. This symptom is considered a sign of pathology.

Why does the bladder feel full?

The reasons for incomplete emptying of the bladder are associated both with disruption of the genitourinary system and with pathologies of other organs and systems. Most often, the feeling of incomplete urination occurs when there is inflammation in the urinary organs.

The patient may have cystitis, an inflammation of the lining of the bladder. Against this background, swelling of the mucous membrane of the organ develops, the lumen of the hole through which urine is discharged out decreases. Due to the development of cystitis, fluid accumulates in the bladder cavity, which is why the patient develops symptoms.

Another inflammatory disease – urethritis – can also cause a feeling of urine retention in the organ cavity. The pathology is localized in the urethra. Swelling of the tissue in this area interferes with the normal flow of urine and contributes to its accumulation in the bladder.

A possible cause of the symptom is urolithiasis. It is characterized by the appearance of solid formations - stones. They can form in all parts of the urinary system. When stones form in the bladder, they can block the entrance to the urethra, which leads to impaired urine output.

More rare causes of the symptom may be the following diseases:

tumors of neighboring organs that compress the bladder and interfere with its emptying;
diseases of the spine (sciatica, herniated discs), in which the regulation of the urinary drainage process is disrupted;
urethral stenosis;
a significant decrease in the tone of the muscle tissue of the bladder walls;
constant constipation, in which feces compress the urinary organs.

When establishing the causes of unpleasant sensations, it is necessary to take into account gender characteristics. Thus, in women, the appearance of symptoms can be caused by tissue growths in the uterus (fibroids, endometriosis), as well as ovarian cysts.

The feeling of incomplete emptying of the bladder in men often indicates the presence of pathologies of the prostate gland - prostatitis or adenoma.

Associated symptoms

The feeling of incomplete emptying of the bladder is often accompanied by other symptoms:

lower back pain, which can be cutting, stabbing or aching (the nature of the symptom is determined by the disease due to which it develops);
dribbling of urine, involuntary release of small portions of urine;
feeling of heaviness in the lower abdomen;
painful urination;
increased temperature, fever, weakness;
dysuria – urinary disorders.

The listed symptoms do not necessarily appear due to urinary disorders. Pain, a feeling of heaviness and other unpleasant manifestations indicate specific diseases; the doctor takes their presence into account when making a diagnosis.

Possible consequences of incomplete urine output

If the bladder is not completely empty of urine, this causes other problems with the urinary system. The fluid stagnates in the organ cavity, microorganisms begin to develop in it, which can cause an inflammatory process in the urethra and bladder.

Pathogenic bacteria spread up the urinary system, successively affecting the ureters and kidneys. Therefore, against the background of stagnation of urine, severe kidney diseases, for example, pyelonephritis, can occur.

In extremely rare cases, against the background of weakened immunity, generalization of the infection is possible - the development of sepsis. In this case, the patient’s condition sharply worsens, damage to vital organs is possible, which will lead to death.

In the absence of specific therapy, inflammation in the urinary organs becomes chronic. The patient will periodically experience exacerbations, during which a clinical picture of intoxication appears - weakness, headache, sharp rise in temperature.

Urine stagnation is especially dangerous for pregnant women. Expectant mothers may notice incomplete emptying of the bladder, which is explained by an increase in the size of the uterus. Against the background of this process, complications caused by the spread of infection throughout the body quickly develop.

In addition, when treating women, certain difficulties arise related to the selection of medications. Many effective antibacterial drugs are strictly prohibited for use during pregnancy, as their use can adversely affect the development of the fetus.

Therefore, if symptoms of pathology appear, the expectant mother should urgently consult a specialist in order to prevent the development of severe consequences.

Other possible complications are related to the effect of a full bladder on the organs that are located near it. If urine excretion is impaired, the enlarged bladder puts pressure on them. This can, for example, lead to constipation.

Diagnosis of the disease

If a person does not empty their bladder, it is necessary to determine the cause of this symptom. A wide range of research methods are used to diagnose the disease:

general clinical blood test. Against the background of inflammatory processes, the cellular composition of the patient’s blood changes - leukocytosis develops, and younger elements predominate among the white cells. Due to infection, the erythrocyte sedimentation rate increases;
general urine examination. The analysis is one of the most informative studies in diagnosing diseases of the urinary system. It allows you to detect changes characteristic of certain pathologies. Thus, with cystitis and pyelonephritis, the content of leukocytes increases, in the case of urolithiasis - erythrocytes. A result that corresponds to the norm is a reason to suspect the neurological nature of the disease;
bacteriological analysis. A sample of the patient's urine is cultured for pathogenic bacteria. To do this, the material is placed in a nutrient medium and cultivated for several days. During the study, it is possible to accurately determine the type of bacteria that caused the disease, as well as determine which antibiotics it is sensitive to. This technique is widely used for the diagnosis of cystitis, pyelonephritis, urethritis;
Ultrasound of the kidneys. An instrumental examination of the urinary system allows us to assess the condition of its organs. Using ultrasound diagnostics, it is possible to identify pathological formations that arise in a patient due to urolithiasis;
cystoscopy. For accurate diagnosis, endoscopic examination is used - examination of the bladder cavity using special equipment. An endoscope with a camera is inserted into the organ through the urethra. The sensor transmits an image to the screen of the device, and the doctor can see signs of pathological changes in the bladder and make a diagnosis.

If necessary, other instrumental and laboratory methods can be used for diagnosis. For example, when other methods are ineffective, MRI and CT are often used. These studies provide a layer-by-layer image of all organs of the urinary system. The high information content of these research methods makes it possible to determine the disease even in the most difficult diagnostic cases.

Treatment

If the bladder does not empty completely, the patient requires specific treatment. The choice of therapy is determined by the disease that caused the disturbances. In the presence of infectious processes (cystitis, pyelonephritis), the patient is prescribed antibacterial agents.

The selection of a specific drug depends on the type of pathogen. It can be accurately determined only after urine culture. Before receiving the results of this analysis, the patient is prescribed a broad-spectrum drug, which is then replaced with a more narrowly targeted drug.

Antibiotics must be prescribed by the attending physician. It is strictly prohibited to use these drugs on your own, as their uncontrolled use can cause severe side effects.

If the bladder does not empty due to urolithiasis, it is necessary to remove the stones from the organs of the urinary system. This often requires surgery. Small lesions that can easily come out naturally can be treated with non-surgical methods.

This is done by dissolving the stone with special preparations or crushing it into fragments using special devices. The method of treatment is selected by a specialist taking into account the characteristics of the course of the disease, the characteristics of the stone and the general condition of the patient.

If incomplete emptying of the bladder in women is associated with neurological disorders, then treatment will include taking medications that restore normal innervation of the bladder.

In addition to treating the underlying disease, symptomatic therapy is prescribed to alleviate the patient’s condition. In the presence of severe pain, antispasmodics are used. If the temperature is elevated, non-steroidal anti-inflammatory drugs are used.

To relieve pain, you can use folk recipes, but they should not replace full-fledged drug therapy. Traditional medicine techniques help eliminate the symptoms, but the disease itself will continue to progress. Therefore, self-medication without following the doctor’s recommendations is fraught with serious consequences.

After completion of therapy, the patient is prescribed a course of rehabilitation. It includes:

physical therapy, special gymnastics;
massage;
physiotherapeutic procedures;
long walks in the fresh air;
therapeutic diet, limiting the consumption of harmful foods;
correct drinking regime, in some cases – limited consumption of liquid and salt.

Complete rehabilitation ensures rapid recovery of the patient and prevents the development of complications. Preventive procedures are aimed at combating relapse of the disease and the transition of the pathology to a chronic form.

Conclusion

Thus, incomplete excretion of urine is a sign that indicates a dysfunction of the urinary organs. When there is a feeling of incomplete emptying, especially if it persists for a long time, you need to consult a doctor and undergo all the necessary examinations.

Ignoring a symptom or prolonged absence of treatment can cause a number of serious consequences that significantly reduce the patient’s quality of life.

Mechanisms of disease development

The normal functioning of certain areas of the brain and spinal cord, as well as peripheral nerves responsible for the processes of accumulation and excretion of urine, ensures the physiological functioning of the bladder.

With neurogenic dysfunctions, a number of pathological conditions of the bladder arise, which have a single symptom - urination disorder.

Urologists, including specialists from Germany, believe that proper emptying of the bladder occurs due to the interaction of various muscle groups and nerve endings. Muscles cannot contract effectively and in a timely manner if the nerves are injured or affected by disease.

This leads to a change in the tone of the smooth muscle wall of the organ, which is most often expressed as urinary incontinence. Urine is released involuntarily without the urge to urinate.

Neurogenic bladder: where to go for help?

Any specialist who studies neurogenic bladder knows that Germany has trained many doctors who thoroughly understand this disease. The neurogenic bladder requires appropriate treatment, which requires highly qualified doctors and modern equipment. Therefore, it is not very surprising that residents of the post-Soviet space prefer to go to German clinics, which have become a standard even for citizens of developed countries. In Germany, neurogenic diseases of the urinary system are successfully treated with conservative and surgical methods.

Treatment options for neurogenic bladder in German clinics

Irregular structure or disruption of the integrity of the urinary tract requires surgery.

If the pathology is caused by a weakening of the musculoskeletal system, the following is prescribed:

restorative therapy,
hormonal drugs,
gymnastics.

This is observed in women and is associated with:

menopause,
exhaustion,
birth injuries,
decreased muscle tone.

If urinary incontinence is caused by an obstacle to its normal outflow (prostate adenoma, gonorrhea, other changes in the urethra), surgical measures are taken.

German clinics for the treatment of neurogenic bladder are famous for their outstanding surgeons.

Neurogenic bladder, associated with various lesions of the nervous system, in children most often manifests itself as involuntary urination during sleep. Medicines, physiotherapeutic procedures and psychotherapeutic influences, when used correctly, give good results.

Certified and internationally recognized German specialists in the field of urology and related disciplines are a guarantee of receiving quality care for a diagnosis of neurogenic bladder.

Berlin

In the city of Berlin, Dr. Kurt Miller works at the Charité University Hospital. The professor is a leading expert in the field of:

treatment of urinary incontinence,
pediatric urology,
treatment of neurogenic bladder caused by prostate diseases.

Charite is one of the largest clinics in Europe. It is famous for the largest number of Nobel laureates in Germany. Many German specialists teach internationally in the treatment of neurogenic bladder.

Urologists at the Charite Clinic are working to create as many treatment options as possible that do not require hospitalization. But if the choice still has to be made in favor of surgical intervention, then they demonstrate the highest skill.

The latest advances in medical technology are used:

expensive laparoscopic equipment,
laser,
robot Da Vinci,
PET-CT diagnostic complexes.

The structure of the Charité is organized in the best possible way for patients. This is what distinguishes German clinics for the treatment of neurogenic bladder. Here, patients not only receive optimal care; medical competencies are combined in the form of interdisciplinary departments.

The Department of Urology, headed by K. Miller, has an excellent reputation among men, women and children living in different parts of the world. The development of a medical care plan is carried out in close cooperation with the patient and is characterized by a high degree of individualization of treatment.

Freiburg

Urologists at the Black Forest-Bahr Clinic, located near Freiburg, successfully diagnose and treat urinary disorders and urinary incontinence. The Urology Department is headed by Professor Alexander Lampel.

Among the patients, men predominate, since surgeons specialize specifically in eliminating problems of the male genitourinary area. Over the past five years, Focus magazine has included the clinic among the best in the country.

Munich

The urological clinic in Munich is headed by Professor Friedemann Meisse. This specialist has been treating neurogenic bladder for many years and Germany has become in demand by foreign patients largely thanks to his efforts.

Advanced screening is successfully combined with innovative methods of surgical treatment. Therefore, the number of foreign patients is growing steadily.

Another Munich clinic is no less famous - LMU. At the Ludwig Maximillian University, outstanding research in the field of urology is carried out and immediately implemented in practice. Robotic urological surgery is considered an important advantage of the clinic, which is headed by Dr. med., Professor Christian Stief.

Minimally invasive urology and endoscopic surgery in Germany for neurogenic bladder is complemented by Greenlight technology (green laser).

When choosing a conservative treatment route, the following is prescribed:

paraffin therapy,
ultrasound,
electrophoresis of antispasmodics and anticholinergics.

Hanover

Bladder weakness is caused by various bladder lesions that cause urinary incontinence. To eliminate them, many patients come to the Osnabrück clinic, which is located near Hannover. Doctor of Medical Sciences Goetz Kubik, according to patients, is the competent specialist who makes it possible to travel long distances and come to a clinic in Germany for treatment of a neurogenic bladder.

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