Bladder dysfunction refers any condition where the bladder is incapable of emptying or storing urine properly. Patients can have urinary leakage, difficulty emptying the bladder, pain, burning, spasms or a combination of these symptoms.
Most of the patients who have bladder dysfunction are categorized into mechanical or functional dysfunction. Mechanical results from prostate enlargement, bladder stones, bladder tumors or alterations in the anatomy of the lower urinary tract. Functional are related mostly to neurologic conditions which render the bladder either weak or completely nonfunctional. These conditions include spinal cord compression, spina bifida, spinal cord injury, stroke, multiple sclerosis, parkinson's.
Symptoms of bladder dysfunction can range from frequency, urgency, and leakage of urine to complete retention. In addition patients can void in small amounts or experience dribbling when the bladder has decreased contractility.
Detection of any patient with bladder dysfunction involves an accurate history and physical exam, urinalysis, urine culture, cystoscopy, and special testing called urodynamics. Urodynamics involves filling of the bladder with fluid to assess the amount of urine a bladder can hold, the pressures within the bladder during filling, and any abnormal contraction in the bladder, urethral and even rectum.
Treatment of bladder dysfunction depends on the cause. If this cause is mechanical then removal of the obstruction, stone, or tumor can relieve the dysfunction. If it is neurologic or functional, then treatment consists of medicine to either reduce the overactivity of the bladder or catheterization of the bladder when there is urinary retention.
Prevention of bladder dysfunction is related to management of the primary urologic, medical or neurologic condition. Medications can stabilize and reduce symptoms but surgical intervention is often necessary. It is important to not ignore symptoms such as frequency, urgency, inability to empty the bladder. Hydration is again very essential. Notifying the primary care physician of any change in urinary symptoms leading to an early discovery of the underlying problem is tantamount.