No. of neurogenic bladder patients on rise

By Lee Kyung-min

The number of patients treated for neurogenic bladder disorder, symptoms that include an inability to control urination, increased 6.6 percent on year over the past five years, government data showed Sunday.

According to data from the National Health Insurance Service (NHIS), 415,000 people sought hospital treatment for the disease last year, up 6.6 percent from 301,000 in 2011.

Of them, more than a third, or 34.1 percent were those in their 70s and over, followed by those in their 60s (19.4 percent), and 50s (17.4 percent).

About 266,000 patients were women, almost double the number of men at 148,327. Men mostly suffered from benign prostatic hyperplasia, a common condition men get as they become older, in which the prostate gland gets bigger and causes difficulty in urinating. Women had it due to peripheral nerve or central nervous disorder.

Aggregated treatment costs also increased to 84.4 billion won ($77.7 million) last year, up 10.6 percent from 51.1 billion won in 2011.

Those who have the condition lack bladder control due to brain, spinal cord or nerve damage, which can be caused by among other things, Parkinson’s disease, diabetes or multiple sclerosis. The nerve damage can also be caused by heavy metal poisoning and strokes. People born with problems in their spinal cord may also have the problem.

Its symptoms include a weak urinary stream, frequent urination, indicated by urinating over eight times a day, and a feeling of the need to urinate immediately and not being able to do so. Others have painful urination, which may indicate a urinary tract infection.

Surgical treatment following early diagnosis is recommended to treat what many patients find an embarrassing disease, an expert said.

“Many patients aged over 60 particularly find it embarrassing to have this condition, which may be caused by a nerve-related disorder, not a lack of self-restraint stemming from mental incapacity,” said NIHS Ilsan Hospital Urology professor Lee Suk-young. “It is also manageable,” he added.

The nerves and muscles of the urinary system have to work together simultaneously to retain and remove urine when a person wants to. This requires tightening or releasing of the muscles through nerve-carried messages between the bladder and the spinal cord and brain, and problems occur when the system does not function properly. The most effective way to treat this is through surgery.

“Treatment for neurogenic bladder is largely determined by what caused it. The priority is to prevent kidney damage,” he said.

Various methods can be undertaken including regularly emptying the bladder with a catheter, a thin tube, which can be inserted into the body, through which a patient urinates. Preventive antibiotics intake is required to reduce infection.

Doctors sometimes place an artificial cuff around the neck of the bladder for it to inflate and deflate to help a patient hold urine and release it. Similarly, an electrical device can be placed on nerves located in the lower back above the sacroiliac area of the pelvis to stimulate or slow down bladder activity.

In order to remove stones or other blockages inside urinary tubes, surgery is the only way. Botox or other drug injections into the bladder muscle are among other options to treat non-obstructive causes.

Regardless of treatment methods, Lee added, continued attention is required to manage symptoms over the long term, as not doing so could cause kidney failure, urinary tract infections and other complications, which are detrimental to patients already suffering from serious diseases.

Serious infections of the bladder or kidneys, for example, could occur, if a patient sees blood in their urine, experienced by many of ureteral cancer patients.

This happens when blood vessels in the kidney are damaged as a result of the bladder becoming too full and urine backing up into the kidneys, instead of being removed from the body.

“Regular checkups are crucial to monitor the disease, and to prevent such possible complications,” he added.

Other than the medical treatment, drinking plenty of water and limiting the intake of caffeine is recommended for every day practice, Lee added.

“Frequently drinking water helps the body remove urine. Patients should also refrain from eating too salty and spicy food.”