Overactive Bladder Causes, diagnosis and modern treatment
Neurogenic bladder is a disease that affects the bladder due to a pathological disorder, or from neurological diseases or chronic inflammatory diseases, the latter being the most prevalent among women than men.
The overactive bladder is defined as a pathological condition that affects the bladder after being exposed to chronic infections or accidentally exposing the spinal cord to an accident that is totally or partially damaged or the patient is infected with MS, and these pathologies lead pathologically to an increase in the production of neurotransmitter (acetylcholine), which It is excreted from parasympathetic nerves regularly, but in the case of a high percentage in the wall of the bladder, it stimulates the muscarinic nerve receptors and the neurotransmitter to the brain, causing superior effectiveness of the bladder muscles and leading to urinary incontinence and leakage of urine without prior warning and such As leading to a sudden feeling of salt to empty the bladder before filling up the physiology (400-300 mm) urine.
The modern pathophysiological background of the reasons for the increased effectiveness of the bladder muscle has indicated the presence of multiple pathological factors, namely:
1- Neurological cause: It is either due to super excitability coming from the center of urination in the brain (Pontium), or it is due to the loss of bladder suppression in these upper central regions, and as in the case of neurological diseases such as MS, due to the physiological suppression of the bladder leading to To a high activity in it with an extraordinary contraction of the bladder muscle, and this is what is also diagnosed in the case of spinal cord injury causing accidental damage in these patients to a decrease in the central cerebral suppression of the bladder and causing an increase in arousal and causing the formation of reflexes stimulating nervous bladder fibers leading to Z changes the same pathological nerve bladder high efficiency.
2- Muscle Cause: Recent studies have shown that changes in the sensitivity of the bladder to stimulating substances present in the urine are the cause leading to the nervous bladder.
As this high sensitivity over time leads to changes in the cells of the bladder, causing the production of a superficial protein inside the muscarinic receptors, and then leads to the highly active neural bladder.
3- Bladder cellular cause: There are membranous endothelial cells in the bladder, which are the barrier between the stored urine and the muscular bladder wall. In this region of the bladder there is a dense amount of final nerves, as well as cystic cells, which have the effect of organized rhythmic excitement in the bladder. For these cells, it is through these three types of cells in the bladder (endothelial cells, muscle cells, and stromal cells) that the bladder acquires a feeling of early fullness leading to its contraction and then discharge from urine without prior warning.
4- The specific reason for the cellular substances: the various cellular substances in the bladder (muscular, nervous, stromal, and membranous) may lead to a change that occurs in the natural physiology of the bladder, which causes super excitement leading to the muscular spasticity.
The effect of Botox on the tips of the nerves:
The effect of botox (neurotoxin extracted from botulinum basil) after we have examined the pathological causes leading to the activity of the overative bladder, it is necessary for us to explain to the reader how this substance affects the complex cellular complex in the body in general and the bladder in particular in order to understand how this substance works to restore Physiological functions and normal sensitivity of the bladder during urine filling to normal.
After treating the bladder with this substance by injecting it into its wall, the following occurs:
- Partial changes in the mechanism of the motors of the bladder nerves transferred to the higher nerve center.
- Reducing the cystic allergic receptors.
- Reducing nerve sensitivity in the bladder membrane.
- Blocking the release of choline, whose primary physiological function is to shrink the bladder muscle to empty the urine after secreting it from the parasympathetic nervous system and the bladder muscle.
- Reducing indirect peripheral nervous sensitivity by reducing central allergies leading to a reduction in chronic pain in the bladder, but it does not affect acute pain in the bladder.