Diagnosis of a neurogenic bladder
Last reviewed: 23.04.2024
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The state of the bladder is estimated by the number of spontaneous urination per day for normal drinking and temperature regimens. Deviations from the physiological rhythm of spontaneous urination are the most common symptoms of a neurogenic bladder.
To determine the type of neurogenic bladder, it is necessary to study the rhythm and volume of urination and conduct a functional study of the bladder.
The number of urination more than 8 times a day determines the hyperreflexive type of urination, urination 2-3 times a day - hyporeflective type.
An evaluation of the function of urodynamics of the lower urinary tract is performed based on uroflowometry, retrograde cystometry, urethral profilometry, intravesical pressure measurement with natural filling of the bladder, electromyography of the anal sphincter and pelvic floor muscles, pharmacocystometry.
Uroflowmetry is performed with a device that fixes the volume and speed of urination. Rapid urination is a sign of hyperreflexia, a flattened curve indicates an increase in urethral resistance, intermittent urination occurs with vesicoureteral dissyncia.
The profilometry of the vesicourethral segment shows the profile of the pressure change at the end of the catheter with its uniform extraction from the urethra and gives an idea of the organic or functional disorders in the lower parts of the urinary system.
Pharmacocytometry allows an objective assessment of the reaction of the bladder to certain medications. Electromyography of the external anal sphincter is used for indirect evaluation of the function of the sphincter of the bladder.
When carrying out ultrasound of the bladder, you can see the unevenness of its contours, increase or decrease in its size, incomplete emptying of the bladder. Cystograms show uneven contours, changes in the shape of the bladder, and sagging of the cervix. With the help of uroflowmetry, there is diagnosed uterine-urethral dissynergy. On the radiographs of the spine, the indentation of the lumbar vertebrae is diagnosed in about 13% of cases.
Norms of circadian rhythm and volume of urination in children
|
Index |
Girls |
Boys | ||||
|
4-7 years |
8-11 years old |
12-14 years old |
4-7 years |
8-11 years old |
12-14 years old | |
|
Number of urination per day |
6-7 |
5-6 |
4-6 |
5-7 |
5-6 |
4-5 |
|
Volume of the bladder, ml: | ||||||
|
Minimum |
68 |
50 |
115 |
63 |
46 |
140 |
|
Maximum |
161 |
235 |
270 |
135 |
272 |
325 |
|
Average |
130 |
155 |
197 |
107 |
140 |
190 |
Despite the meager symptomatology of the initial stage of non-irogenic bladder dysfunction, its consequences are severe enough, and with time, are less amenable to therapeutic treatment. Therefore, if the first signs of the disease are found, it is necessary to begin treatment aimed at correcting the consequence of hypoxia, preventing the infection of the urinary system and normalizing the bladder.
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