Hi guys, i'm confused in urinary incont.
could anyone explain the diff between Neurogenic bladder and detrusor instability and detrusor dyssyneriga?
also when to use oxybut or bethanechol in each??
neurogenic bladder due to nervous sys affected -> like stroke, multiple sclerosis, spinal cord injuries --> can cause over active bladder ( sudden urge to urinate) or underactive bladder( urine leaks out once the bladder pressure is more than the urethral pressure ) depending on the nerve involved and nature of injury.
detrusor instability is stong sudden need to urinate, following which bladder contracts leading to urine leakage.
detrusor dyssynergia is disruption in CNS regulation of micturation resulting in dyscoordination btw detrusor muscles and urethral sphicters, causing flow interrupted.
oxybutynin is used in urge incontinence as it inhibits smooth muscle contraction. and bethanechol used in overflow incontinence (contracts sphincter muscles).
this is very confusing topic, and please correct if i am wrong.
GL
I though neurogenic bladder causes overflow incontinence???
yes neurogenic bladder causes overflow incontinence, that is what i meant by underactive bladder. when the bladder pressure increases more than urethral pressure, urine leaks out.