Spinal bladder - Causes, symptoms and treatment. MF.

Spinal bladder is a violation of the bladder function, which develops due to a violation of its innervation by the fibers of the spinal cord. Spinal bladder is a special case of a neurogenic bladder.

Causes of spinal bladder

The main cause of the spinal bladder is a spinal injury with a ruptured or damaged spinal cord. As a result, the innervation of the bladder is disrupted and a typical clinical picture develops. In addition to traumatic injury, other factors can also cause the spinal bladder. For example, malignant or benign neoplasms that develop in the spinal canal can pinch the spinal cord, which also causes the development of the spinal bladder.

Spinal cord rupture

There are cases in the literature where the symptoms of the spinal bladder developed after an unsuccessful spinal surgery. A similar disease is called the iatrogenic spinal bladder, which indicates the development of pathology due to unsuccessful physician intervention.

In addition, a paralytic effect on the nerve roots of the lumbar region may have some potent toxic substances. Therefore, with the typical symptoms of the spinal bladder, it is necessary to take into account the history of the disease - did the patient take shortly before the development of the symptomatology of suspicious substances.

Symptoms of the spinal bladder

The clinical manifestation of the spinal bladder is only one - it is urinary retention. True, it is somewhat different from the delay of urine, for example, with adenoma or prostate cancer. The main differential sign of the spinal bladder is that it is accompanied by a disruption of the function of other pelvic organs and lower limbs.

Another feature is that even with a full bladder, the patient does not feel pain. This can result in a rupture of the organ and urine entering the abdominal cavity, followed by the development of peritonitis, the outcome of which may be different, even lethal.

Of course, with a traumatic spinal cord injury, when paralysis of the lower limbs and intestinal dysfunction occurs, the patient immediately hospitalized. A different situation can be observed with a tumor of the spinal cord, when the bladder paralysis is the only symptom. In this case, patients quite often look for the cause of urinary retention in prostate pathology and are treated independently by folk remedies. This leads to the aforementioned complications. Therefore, with a delay in urination, especially painless, you should immediately contact a urologist to find the cause of the problem.

Diagnosis of the spinal bladder

At the very beginning, it is necessary to determine whether urine enters the bladder or is not even filtered by the kidneys. For this purpose, the is produced by the urethral catheter .If the tube leaves the urine, then the problem is not in the kidneys, namely in the sphincter apparatus of the bladder, which is innervated precisely from the spinal cord. In this case, if the urine retention was more than 24 hours and the bladder was stretched more than usual, the integrity of the vessels of its wall could be broken and an impurity of blood could appear in the urine. To this situation, you need to be prepared not to confuse the spinal bladder with glomerulonephritis, in which bloody urination can also be noted.

For final confirmation of the normal functional state of the kidneys, excretory urography can be performed. To do this, a contrast agent is injected into the vein, after which the pelvic region is examined under X-rays. If the kidneys function normally, then a contrast agent is recorded in the bladder.

To determine the exact cause of the disease, MRI and CT of the spine are recommended. These studies make it possible to detect traumatic damage or neoplasm, which became the cause of pathology. These studies are extremely necessary to determine the tactics of treatment, in particular, to choose the place of operative access.

Another method for detecting the pathology of the spinal cord can be considered spinal puncture .If the patient has a traumatic injury, a blood impurity will be found in the cerebrospinal fluid, in oncopathology the cerebrospinal fluid contains a large amount of protein.

Treatment of the spinal bladder

Treatment of pathology depends on its cause. If the patient has a proven oncology process, then surgery is performed, the purpose of which is to remove the tumor. In case of traumatic injury, in the case of subarachnoidal hematoma, an operation for the elimination of a blood clot can also be used.

Fractures of the spine, accompanied by ruptures of the spinal cord, should be treated in a neurosurgical hospital. After the operation on stitching of the spinal cord is performed, a person needs to immobilize with special vertebral buses. In this position, patients can stay for up to a year until the fracture consolidation is complete. It is worth noting that not always such tactics yield positive results, but today it is the only effective method of treatment for such patients.

In parallel with the treatment of the underlying cause of the disease, procedures are performed to evacuate urine from the bladder. There are different methods, but all these should be aimed at preventing secondary infection. The most dangerous technique is staging a conventional urethral catheter, which almost always ends with inflammation of the mucous membrane of the bladder. If there is no possibility of establishing another urinary evacuation system, the urethral catheter should be placed under local and general cover with antibiotic therapy.

Probably, the Monro inflow and outflow system can be considered an ideal technique for washing the urinary bladder and evacuating urine. The device consists of a conventional urethral catheter, to which two tubes are connected at once. One system is connected to the antiseptic solution located above the patient's bed, and the second is lowered into the vessel, which is under the bed of the patient. Thus, under the force of gravity, the antiseptic enters the bladder, where it neutralizes the bacteria and, together with the urine, flows into the jar under the bed.

System monro

Features nutrition and lifestyle with spinal bladder

However sad it may sound, but such patients, in general, lead a sedentary lifestyle. To this they are forced to adapt to a special disability inventory, which can improve the quality of life.

As for the diet, it repels from poor intestinal motility. Patients, in order to avoid constipation, it is necessary to take liquid and fried food, which is easily digested, and the remnants also easily leave the intestine.

Rehabilitation after illness

Patients with a spinal bladder, who are mostly disabled in most of their cases, need psychological support first. For this purpose in our country there are special centers for the rehabilitation of disabled people. There they are both physical and psychological exercises that allow you to train the working areas of the body and increase the tone of the nervous system. Today, for the disabled, good conditions have been created. They even have the opportunity to compete in sports competitions, where they compete with the same people.

The main task of medical personnel, which serves the patient in the first weeks of the disease, is strong physical and moral support, so that he does not have stupid and unnecessary ideas.

Treatment of the spinal bladder with folk remedies

As it was already possible to guess that the treatment of folk remedies in such a situation is not that inefficient, but simply inexpedient. Patients with similar problems, in order to get at least the slightest chance of recovery, should receive serious and qualified medical care from the first days. It is worth noting that every year the level of recovery of spinal patients is markedly increased.

Complications of the spinal bladder

The first complication that a patient can expect is a bladder rupture with the formation of peritonitis and death. To avoid this, it is necessary to immediately connect to the treatment of a urologist, so that he can evacuate urine from the bladder in time and correctly.

Since patients with a spinal bladder permanently live with a urethral catheter, it must be periodically changed. The catheter, which is in the urethra for more than three days, can cause bedsore and gangrenous urethritis. In the future, a man can threaten with an operative intervention - amputation of the penis.

Do not forget about bedsores that can form on the skin of those areas that fit tightly to the bony protrusions on the human body.

The urine evacuation and bladder flushing system must be constantly cleaned and changed. There have been cases when the tube of the catheter was clogged, which led to the accumulation of urine in the bladder and contamination of blood.

Prophylaxis of the spinal bladder

It is clear that it is difficult to prevent the disease itself. Try to do this should people who are engaged in traumatic sports or work in dangerous conditions. To date, there are many special corsets and belts that protect the spine from fractures and bruises in the fall and bumps.

Also about your safety, you need to worry about driving, since the greatest number of spinal injuries occurs there. In this situation, the only means of prevention can be a car with airbags in the cabin.

More attention should be paid to the prevention of complications of the spinal bladder. So, pressure sores can be prevented, using special mattresses or trite bags with sand, which are placed under the bony projections on the human body. In addition, it is necessary to ensure that there is no wrinkling on the bed linen, and the patient's body is constantly turned over and not in one position, which contributes to the stagnation of blood and the formation of decubitus.

Rev.doctor urologist Astashin Е.Е.