The nerve vessels that operate the bladder and anus are congenitally damaged.
Normally, when the bladder is filling, its wall is loose and the urination gate is closed to prevent urinary incontinence. During urination, the urination gate opens and the bladder contracts and expels the urine. In neuropathic disorders, this relationship between the bladder and the bladder is disrupted.
Although the urinary system and intestine are normal at first, they later become seriously impaired.
As age progresses, the pathology increases and serious damage occurs. For this reason, follow-up should begin from the neonatal period.
What are the causes? During pregnancy, folic acid deficiency leads to these anomalies. The most common causes are a mass holding the nerves in the waist area called Myelomeningocele and closed nerve disorders in the waist called Spina bida. Additionally, many disorders in the middle region of the waist, which sends nerves to the bladder, can cause this.
How is it diagnosed? These children present to the hospital with urinary infection, difficulty urinating or urinary incontinence. In most cases, the diagnosis is made by examining the mass and disorder in the waist area. However, the type and severity of bladder dysfunction are determined through important examinations.
Ultrasound shows thickening of the bladder wall and enlargement of the kidneys and urinary tracts. In voiding cystourethrography, urine leakage from the bladder to the kidney and bladder wall deformity are observed. Urodynamics shows the type and severity of bladder disorder.
What problems does it cause?
• Urinary infection
• Urinary incontinence
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• Impaired functioning of the bladder and intestine
• Impairment in the kidneys and urinary ducts
• Impairment in sexual function
How is it treated? Preventive antibiotics are given to prevent urinary infection, which is one of the most important problems. Bladder relaxants are used to relax the bladder muscle, reduce pressure and increase bladder capacity. Stool softeners and various medications are prescribed to treat and prevent constipation. Since most of these children cannot fully empty their damaged bladders, their bladders are emptied with the help of a catheter every 3-4 hours every day for life.
Why is surgery performed? A large capacity and low pressure bladder is created to protect the kidneys. Additionally, it prevents urinary incontinence for life. The bladder outlet is narrowed around the age of 5, when bladder development for labor is completed.
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