VOIDING DYSFUNCTION refers to the inability to empty the bladder normally.

Neurogenic Bladder:  the muscles and nerves of the urinary system work together to hold urine in the bladder and then release it at the appropriate time.  Nerves carry messages from the bladder to the brain and from the brain to the bladder telling them to either tighten or release.  In a neurogenic bladder the nerves carrying these messages do not work correctly.

Problems associated with a neurogenic bladder:

Urine Leakage

Urine Retention

Damage to the tiny blood vessels in the kidney

Infection of the bladder or ureters

Causes of a Neurogenic bladder include:

Diabetes

Acute infections

Accidents that cause trauma to the brain or spinal cord, other diseases (such as Multiple Sclerosis, Parkinson's Disease, brain tumors, etc)

Diagnosing a Neurogenic bladder - physical exam and evaluation often by both a urologist and a neurologist;   imaging of the bladder and ureters;  urodynamic testing

Treatment:  A treatment plan will be developed based on the individual but may include such things as:  medication, pelvic floor rehabilitation, neuromodulation (acupuncture, Interstim Therapy), catheterizations, surgery.

Obstructive Voiding Dysfunction-includes cystoceles, urethroceles, enteroceles and rectoceles.  These disorders involve protrusion or an organ into the vaginal canal:  Cystocele (bladder), urethroceles (urethra), rectocele (rectum).  Symptoms include pelvic or vaginal fullness or pressure or the sensation that your organs are falling out especially when straining or coughing.  Women can experience dyspareunia (painful intercourse). Incontinence may develop including fecal incontinence.

Diagnosing Obstructive Voiding Dysfunction - physical exam and evaluation, bladder scan, urodynamic testing.

Treatment:  pessary, pelvic floor rehabilitation, sling surgery.   Pessaries are prostheses inserted in the vagina to help keep the organs in place.  Pessaries come in various shapes and sizes.  It is important that they are sized correctly and cleaned at least 1 time a month but more often is suggested.    Pelvic Floor Rehabilitation are exercises performed to strengthen the levator ani muscles (muscles that support the pelvic organs).  Surgical Repair is used when other treatment options have failed or the individual problem warrants surgical intervention.  Several types of slings are used and the type will be determined by the physician based on the individual patient.  Mini Arc and Sparc are two types of slings frequently used.  click on the Women's health link to see more information.