Urinary Problems

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Urinary and bladder control problems when hemosiderin has built-up along the spinal cord and nerves are prevalent problems. Our bladder function is coordinated by an autonomic nervous feedback system that loops between your bladder, spinal cord, and brain. Nerves allow your conscious control of specific functions, and different nerves control involuntary actions. Urinary dysfunction is a common symptom of superficial siderosis patients. It often results from a dysfunction of the brainstem that controls urination and small fiber autonomic neuropathy.

Incontinence And Leakage

The sacral spinal nerves, S2, S3, and S4, control urination by allowing the upper part of your bladder to contract, the bladder neck, and the external urethral sphincter relaxes, allowing urination to begin. Sympathetic nerves located between the thoracic T11 through lumbar L2 are responsible for allowing the bladder’s upper section to relax and the bladder neck to contract, resulting in urine storage. This urine storage action is also a voluntary function. These are also the nerves responsible for the involuntary function of keeping the internal urethral sphincter tightened, so the urine will not pass. Incontinence, leakage, and increased urinary frequency are common problems when these nerves are affected.

Incomplete Voiding

One more way your bladder control may fail is by not allowing the complete emptying of your bladder. Your parasympathetic nerves control the internal urethral sphincters’ involuntary reflex movement. When urine in your bladder builds to 8ozs (250ml), nerves in your bladder muscle start sending a slight urge to pass urine. A healthy bladder should hold close to double this urine amount before you feel an urgent need to void.

When your bladder is full, stretch receptors will send a message to begin the subconscious micturition reflex. Uninterrupted communication between your nerves with the pons and cerebrum allows the control of your external urethral sphincter. If your bladder can not empty, you find yourself having to void again within minutes. An ultrasound can determine if your bladder is unable to empty.

Self-catheterization

If your ultrasound reveals your bladder fails to empty at least one-third of capacity, your doctor may prescribe scheduled self-catheterization. You or a caregiver will insert a flexible plastic tube, called a catheter, into the urethra and up to the bladder. This will allow your bladder to fully empty and reduce the risk of infection. If self-catheterization doesn’t control the problem, you may need a permanent catheter, known as a Foley catheter.

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Updated: November 9, 2020

Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairment, nystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthria, hyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245
Living With SuperficialSiderosis Website PubMed Reference Library 

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