Bladder problems in superficial siderosis are common as the condition progresses. Urine is made by the kidneys and travels through two tubes into the bladder for storage. When all things are working correctly, a person’s urine is stored until four to eight ounces of fluid accumulate. Next, nerves in the bladder first signal the spinal cord, which then tells the brain that the bladder needs to be emptied. Then, as a person prepares to urinate, the brain and spinal cord signal trigger the voiding reflex, which causes two things to happen.
- Your bladder muscle contracts to push urine out of the bladder
- The external sphincter — which normally remains closed — opens to allow urine to leave the body
Common Superficial Siderosis Urinary Problems
Bladder dysfunction is common in the mid-late stage of Superficial Siderosis. Malfunctioning nerve signals in the central nervous system (CNS) areas that control the bladder and urinary sphincters can act in one of two ways. A spastic (overactive) bladder that cannot hold the average amount of urine, or a bladder that does not empty properly (retains some urine in it).
Overactive Bladder Symptoms
- High frequency and/or urgency of urination
- Overactive nighttime urination (nocturia)
- Incontinence (the inability to hold in urine)
- Hesitancy in starting urination
- Inability to empty the bladder completely
Your bladder control may not allow the complete emptying of your bladder. Your parasympathetic nerves control the internal urethral sphincters’ involuntary reflex movement. When urine in your bladder builds to eight ozs (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 should send a message to begin a subconscious reflex. Uninterrupted communication between your nerves with the pons and cerebrum allows the control of your external urethral sphincter. If your bladder will not empty, you find yourself having to void again within minutes. An ultrasound can determine if your bladder is unable to empty.
Managing Your Options
Some early bladder problems might be managed successfully with lifestyle modifications, medication, physical therapy, or nerve stimulation procedures.
Lifestyle Changes To Try
- Restricting fluid intake up to a few hours before bedtime,
- Bladder training for planned urination
- Pelvic Floor physical therapy for overactive bladder targets the group of muscles attached to the pelvic bone and sacrum that control bladder function. The therapy includes biofeedback, neuromuscular stimulation and daily home exercises, to strengthen the pelvic floor muscles, improve muscle control, and promote muscle relaxation.
- InterStim® is a small device surgically implanted under the skin that stimulates the sacral nerves and is used to treat overactive bladder and urinary retention.
- In Percutaneous Tibial Nerve Stimulation (PTNS) a tinyneedle electrode is inserted in the ankle. The electrode transmits a signal to the sacral plexus (a network of nerves that controls the bladder and pelvic floor muscles). A weekly 30 minute treatment for three months has been sucessfull in reducing urinary frequency, urgency, nighttime urination and incontinence.
- Intermittent self-catheterization (ISC) may be needed for difficulty in emptying the bladder. In ISC, you or a caregiver will insert a small tube (catheter) into the urethra to empty the bladder, and then remove the catheter. ISC one or more times per day can help control bladder leakage, urgency and frequency, and nighttime urination in people who cannot completely empty their bladder on their own.
The National Association For Continence offers a free Six-week Guide to Beter Pelvic Health
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