Ineffective bladder, also known as underactive bladder: Symptoms and remedies
Atonic bladder, a condition where the bladder muscles do not contract properly, can cause difficulty urinating or completely emptying the bladder. This article provides an overview of the common treatments and management strategies for atonic bladder.
Initial Treatment
Clean intermittent catheterization is often the initial treatment for atonic bladder. This process helps empty the bladder when it cannot contract properly. If an individual cannot perform self-catheterization, a doctor may suggest a long-term suprapubic catheter.
Pharmacologic Treatment
Pharmacologic treatment with bethanechol, a cholinergic agent, can stimulate bladder muscle contraction. The dosing for neurogenic bladder starts with 5-10 mg orally, repeated hourly up to 50 mg if needed. Maintenance doses range from 10 to 50 mg taken 3-4 times a day. Effects typically start within 30 minutes and last about an hour.
Behavioral Therapies
Behavioral therapies, such as timed voiding and bladder training, can also improve bladder function. These therapies help train the bladder to contract at regular intervals, reducing the risk of urinary retention and its complications.
Surgical Intervention
In some cases, depending on the underlying causes and severity, other interventions like surgical options or advanced therapies may be considered. However, these are less commonly first-line treatments.
Diagnosis
A cystometrogram, uroflowmetry, ultrasound, and electromyography are tests used to diagnose atonic bladder. These tests help assess bladder function and identify any abnormalities.
Living with Atonic Bladder
While there is no cure for atonic bladder, in many cases, individuals can manage their condition effectively and help prevent complications. In some cases, quality of life can be reduced when an individual cannot manage the condition independently and requires a permanent catheter.
Understanding Atonic Bladder
Atonic bladder is an umbrella term for various bladder conditions related to a brain, spinal cord, or nerve condition. Neurogenic bladder is an umbrella term for similar conditions. Spastic bladder, on the other hand, is a term that describes an overactive bladder, causing a frequent and sudden need to urinate.
Preventing Complications
Certain routines, habits, and prompts can help manage incontinence and urinary retention symptoms. For example, bladder training can help improve bladder function and reduce the risk of complications such as bladder infections, bladder stones, renal stones, kidney infections or damage, and kidney failure.
Advanced Treatments
Sacral neuromodulation may be useful in treating underactive bladder, according to a study. This treatment involves stimulating the sacral nerves, which control the bladder, to improve bladder function.
In complex cases, a doctor may suggest surgical intervention to address the aftereffects of atonic bladder or some of its causes, but the condition itself is not addressed by surgery.
In conclusion, managing atonic bladder focuses on facilitating bladder emptying to prevent urinary retention and complications, complemented by medications that enhance bladder contractility when appropriate. While there is no cure for atonic bladder, behavioral modifications and catheterization can help manage symptoms effectively, allowing many individuals to live independently.
[1] Mayo Clinic. (2021). Atonic bladder. [online] Available at: https://www.mayoclinic.org/diseases-conditions/atonica-bladder/symptoms-causes/syc-20376179
[2] NIDDK. (2021). Neurogenic bladder. [online] Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/neurogenic-bladder
"To further bolster the health-and-wellness aspect of managing atonic bladder, mental-health support should also be considered, as psychological stress can exacerbate symptoms. Therapies-and-treatments such as cognitive-behavioral therapy (CBT) can help alleviate stress and anxiety associated with living with this condition."
"Improving understanding of atonic bladder and its treatment options can contribute to the science surrounding this health issue. By exploring advancements in health-and-wellness, mental-health, and therapies-and-treatments, researchers can develop more effective strategies for managing this condition and potentially even finding a cure."
