Stating that the priority in neurogenic bladder problem is the treatment of the underlying disease, Prof. Dr. Tufan Tarcan said, “Mostly, the damage to the borders is irreversible, but bladder function can improve over time in patients with partial paralysis.” He added: “We are trying to correct the problems that occur in the neurogenic bladder with different formulas. Our goal is primarily to ensure that the bladder is able to store and urinate properly, while protecting the kidneys.”
Neurogenic bladder; Defining it as lower urinary system dysfunction caused by a random neurological disease in both children and adults, Prof. Dr. Tufan Tarcan, “The most common cause of it in children is spina bifida, cerebral palsy and border system tumors. Other diseases of the border system can also be seen less frequently.” he said.
Mentioning that diabetes is the leading cause of neurogenic bladder problem in adults, Prof. Dr. Tufan Tarcan, “Diabetes can disrupt the boundaries that control the bladder. We call it diabetic neuropathy, that is, a nervous disorder that occurs due to diabetes. Neurogenic bladder is also frequently seen in patients with spinal cord injuries, MS, Parkinson’s, cerebrovascular events and herniated disc. The manifestation of dysfunctions in the neurological bladder can be very variable. Because the underlying neurological picture is also very variable.” said.
Diabetics should see a urologist routinely
The diagnosis of neurogenic bladder can sometimes be very easy and sometimes difficult. Stating that spinal cord (spinal cord) injury is the leading cause of neurogenic bladder in adults, Prof. Dr. Tufan Tarcan, “In a traffic accident, ruptures occur in the spinal cord due to a lower back fracture. At that time, the endings under that broken ground unfortunately do not work. On the other hand, neurogenic bladder can be very insidious in conditions such as diabetes. Especially diabetic patients need to be very careful after 10 years. In particular, individuals who have had diabetes for a long time should definitely see a urologist routinely after a while.” he said.
Stating that the priority in neurogenic bladder is the treatment of the underlying disease, Prof. Dr. Tufan Tarcan said, “Mostly, the damage in the end is irreversible, but bladder function can also improve over time in patients who experience a partial paralysis. We are trying to correct the problems that arise in the neurogenic bladder in one form. Our goal is to make the bladder both able to store urine and empty under physiological conditions. If the underlying neurological disease does not improve, our urological treatments are more focused on the treatment of the problem that occurs more than the reason.” said.
The most frequently applied system in bladder emptying is pac intermittent catheterization
Stating that the most frequently applied treatment in bladder evacuation issues, that is, in bladders that cannot be emptied, is the intermittent catheterization formula. Dr. Tufan Tarcan said, “Here, the patient can empty his bladder in this form by applying a thin catheter to his bladder through the urethra 6 times a day. If there is an inability to store urine in the bladder this time, we can apply bladder augmentation treatments or surgeries to enlarge the bladder in our patients. We decide on the treatment mostly in the light of the information we get from the urodynamic studies.” made a statement.
Emphasizing that the neurogenic bladder problem is permanent in some cases, for example in children with spinal cord injury or congenital spina bifida, Prof. Dr. Tufan Tarcan, “In patients with MS or partial paralysis, when the affected area becomes beautiful, there can be improvement in bladder function. But these are limited areas. Often, unfortunately, we cannot reverse the damage that has occurred in the neurogenic bladder.” said.
Urology specialists should pay attention to the neurogenic bladder problem
Emphasizing that there are points that urology specialists should pay attention to in the approach to the neurogenic bladder problem, Prof. Dr. Tufan Tarcan continued: “As a urologist, the first point we pay attention to when we come across a neurogenic bladder is the health of the kidneys. Because in a cluster of patients with neurogenic bladder, very high pressures may occur in the bladder due to the inability of the bladder to store the urine properly. These high pressures can spread to the kidney and cause recurrent febrile urinary tract infections in the kidney and loss of the kidney parenchyma due to these recurrent infections. The first thing we should pay attention to is the kidney health of the patients. Unfortunately, kidney damage cannot be reversed. If you don’t treat it, it goes all the way to chronic kidney failure. It is necessary to ensure that the body can store the urine produced at low pressure and bring it out of the body at low pressure. After protecting the kidneys, our second goal is to keep the patient dry. In this, we have different medical, minimally invasive and surgical treatment methods. The patient, who disrupts the control, may come back as having lost his kidneys completely within a few years. If the follow-up and treatment is not done, almost all of the patients with spinal cord injury and our children with spina bifida quickly face the problem of kidney loss.”
We also recommend patient diapers and bladder pads to patients with neurogenic bladder problems
Stating that they recommend patient diapers and bladder pads to patients with neurogenic bladder problems in order not to cause hygienic problems due to urinary incontinence, Prof. Dr. Tufan Tarcan said, “We recommend diapers especially for patients with urinary incontinence, in the middle of probing, during treatment transitions and during the treatment process. Especially in children with neurogenic bladder, urinary control is provided sometimes not at all, sometimes later. In these tables, we can refer to the patient diaper. The diaper is a helpful and valuable weapon for us.” said.
