did you know that having a condition that affects your brain or spinal cord can actually affect the way your bladder functions I'm Dr Rena Malek urologist and pelvic surgeon and today I'm going to talk about neurogenic bladder or essentially problems that affect the bladder due to neurologic conditions such as spinal cord injuries Strokes diabetes and multiple sclerosis Parkinson's disease and a whole host more I'm going to give you a general overview and if you want to learn more about any of those conditions please comment down below and let me know so to start off when you think of the body essentially parts of the brain the spinal cord all send nerves and signals to the bladder and when there's any disruption in either the brain the spinal cord or the nerves that go to the bladder it can cause problems with the way the bladder functions when we think about problems with the bladder there's two ways to think about it so here's our bladder it has two ureters right here which are the tubes that drain the bladder as well as the bladder itself and then the outlet or the urethra or P tube where the urine comes from this is obviously a female urethra because the male urethra is much longer however you could think about it as a problem with the bladder or a problem with how the urine empties or what we call the outlet of urine you can have problems with the bladder itself where either it doesn't store urine well meaning that urine is leaking out because the bladder is not able to hold urine well or there's a problem with failure to empty meaning that the bladder is not squeezing to empty the bladder itself you can also have these same problems but because of the outlet it can be that the sphincter which is inside the urethra that usually helps keep urine in when your bladder is filling and relaxes when your bladder is peeing is not functioning appropriately or it's very weak or it can be failure to empty meaning the sphincter doesn't relax when it should so like I said when you're peeing the sphincter relaxes and it allows urine to empty out and it really depends on what kind of injury you have it what problem problem will happen will it affect the bladder or the outlet I'm going to go over some of the most common conditions and what we often see as problems with these conditions first type of neurologic conditions we think of are those that affect the brain that can be things like stroke can be things like Parkinson's disease and can be things like trauma to the brain if you've had a brain injury or even Dementia in these patients how I describe it to them is that typically our brain has a break the break is on the bladder so the bladder can fill and not contract and when the bladder is full it sends signals to the brain the break comes off the bladder squeezes and it empties but the break is broken because there's problem with the brain and so now the bladder essentially squeezes before it's full giving you this constant urge to urinate so you gotta gotta go Gotta Go you can't make it to the bathroom and often you're having leakage also patients will experience frequency like need to go to the bathroom very often and sometimes even at night the next category of conditions is called spinal cord injuries and spinal cord injuries it really depends where they are in this spinal cord are they in the top part of the spinal cord what we call suprasacral or are they at the very low part of the spinal cord where they're infrasacral in those who have supersacral injuries we see patients who have issues with not only that bladder problem where they're going very often because their bladder is squeezing before it's ready but we also have a problem with the sphincter the sphincter is often not relaxing in time when you need to empty so they'll feel a lot of urge to go but then they can't empty because the sphincter doesn't relax it's not coordinated with the brain and so this creates a lot of problem and in fact is quite dangerous because what happens is you're getting all this pressure from the bladder squeezing and your sphincter is not opening so where does that pressure go well if you remember how the bladder is it's going to go up these tubes up the ureters and they're attached to the kidneys up here and so that can create long-term problems so if you have a spinal Court injury or something like multiple sclerosis which can also present like this very similarly and you're having trouble emptying your bladder it's very important to see a urologist and get regular follow-up to make sure your kidneys are safe and lastly sacral spinal cord injuries these often present with bladders that actually don't contract at all so these bladders essentially don't work at all they're just expand expand expand like a balloon and they never contract so you can't actually empty the urine very well sometimes people who have this problem particularly actually diabetics often can develop this problem after many many years of having diabetes can overcome it because they can bear down just like you're having a bowel movement or having a poop when you push you can sometimes empty urine that way but these people can also have a sphincter that doesn't work so now they have a bunch of urine and a sphincter that doesn't relax that's fixed and then you're having trouble emptying your bladder and again these people need to see a urologist regularly to get checked because again you can have that same problem where the urine fills and fills and fills backs up to the ureters and causes problems with the kidney also many people who have these issues can also get recurrent urinary tract infections if you want to learn more about how to prevent recurrent urinary tract infections check out my video on that as well but this is a real problem and a huge quality of life issue all this to say is that depending on what you have you may or may not follow the textbook but certainly these can have serious implications for your bladder function and it's really important to see a urologist to discuss what type of neurogenic bladder you might have and how you can fix it and live a better quality of life prevent infections and prevent problems to your kidneys hope you guys found this helpful as always remember take care of yourself because you're worth it foreign [Music]