The article was written by Dr. Le Thu Huong – Rehabilitation Doctor, High-Technical Unit for The Treatment of Cerebral Palsy and Autism – Share99 Times City International Health Hub.
Urinary disorders are a great part of the quality of life of the sick and their families. Urinary disorders also lead to urinary infections, kidney failure, and may cause bouts of reflexive sympathetic disorder (AD) that increase blood pressure, reduce heart rate, headache, can lead to cerebral vascular accidents in people with damage of D6 or more. Therefore, urinary control and diabetes care are an important part of caring for spinal cord injury patients.
1. Common urinary disorders
In the stage of myeloid shock immediately after the injury, the bladder is deactivation (loss of reflexes), after the shock exit, depending on the location of the lesion, the degree of damage, the bladder will have different manifestations of disorders:
1.1. Symptoms associated with urine storage (filling phase)
- Urinary fold
- Night urination
- Urinate multiple times
- Sensory disorders: decreased sensation, loss of sensation, increased sensation, urgent sadness, bladder pain
1.2. Symptoms of urination (extortion phase)
- Little hesitate
- Sub-weak current
- Intermittent minor
- Urinary difficulty, urinary secret
- Xiao long
1.3. Symptoms after urination
- The feeling of urinating does not run out
- Drip urination after urination
In these manifestations, urinary secretes and urination, urination does not run out of paddocks are the most common symptoms.
2. Causes of urinary disorders
Normally, urine is produced from the kidneys, through the ureter 2 ureter to get down, stored in the bladder. 1 normal person has a bladder capacity of 400-600ml. When the bladder is full, it stimulates the end of the sensation of transmits sensory information along the S3 cord to the spinal cord and s lateral muscles in the bladder neck are opened.
At the same time, from the spinal cord broadcasts signals to the cerebral bridge, then to the cerebral cortex. If the environment is suitable (at the subjective will of the individual), the cerebral bridge sends a signal that allows the sysular muscles beyond the urethra to open and urination will be taken place smoothly.
In patients with spinal cord injury, due to loss of neuro-signaling between the spinal cord and the brain, or in some cases damage under the cone of the pulp (ponytail), signals between the bladder and the spinal cord are also affected, resulting in 8 forms of bladder and post-bladder sedular disorders :
3. Diabetes care in patients with spinal cord damage
3.1. Set urination
After damage to the spinal cord, most patients cannot urinate completely on their own, most have urinary insy, urinate, urinate. And these patients usually have a urinary in dinh.
Common types of urination and pros and cons:
This usually is inlet in the post-traumatic stage and should be drawn as soon as possible as soon as the patient stabilizes. In addition, urinary circulation is also used in the exacerbation of urinary infections for continuous drainage of urine during this time. Urinary circulation cannot be set for long due to the risks of urinary infections, pain, bladder bleeding when moving, bladder stones, and inconvenience in daily life
Clean Intermittent Urination (CIC)
It's an hourly type of urination to get urine with a clean cathe tube (usually Nelaton's).
- Advantages: Compared to urinary circulation, intermittent urination shows superiority in independence in daily life. Instead of regularly wearing urinary cathees and urine-containing bags such as urine types, patients will use intermittent urination at certain hours, just like an average person goes to the toilet by the hour. Intermittent urination helps to obtain the entire urine in the bladder in the most physical way like the average person, limiting urination, being active in daily life, not causing the bladder to shrink as small as urinary circulation, limiting bladder stones, limiting the possibility of urinary infections. Depending on the patient's ability to urinate, the volume of urine residuals, the patient has in order to place intermittent urination with different times:
Ordinary people: V sub-residual < 50ml
- if <70ml – Không đặt thông tiểu
- 70-100ml: consider ordering urination once a day
- 100-200ml: once a day: priority booked in the evening before bedtime to get better night's sleep.
- 200-300ml: twice daily in the morning when waking up and in the evening before bedtime
- 300-400ml: 3 times daily
- >400: 4-6 times/day
- Disadvantages: like other types of urination, intermittent urination can cause urinary infections, damage to the urethra, very rarely the possibility of perforation of the bladder. To avoid these disadvantages, patients need to comply with the regulation of esthema, apply gel (water-soluble gel – KY)
Urination on the pubic bone
As an option for patients with spinal injury urination disorders that can not be placed intermittent urination, for example patients with urethral lesions, 2 difficult motor hands (patients with CS neck injuries). Advantages: longer circulation time than urination, less bleeding when moving, can change the information itself
- Disadvantages: there is a risk of urinary infections, shrinkage bladder, bladder stones
For neurological disorders of urination, settings is the most optimal measure to protect diabetes. In addition, at the rehabilitation center, patients can participate in a number of treatments and interventions to improve the problem of urination disorders.
These measures improve the functioning of the bladder and urethral sysic muscles, improve the ability to urinate, alleviate disorders, for example, bladder sensation disorders, bladder pain, urinary insuria, which in early words can improve the quality of life:
- Strong perineal muscle exercises for patients with urinary leakage due to weak urethra sysing muscles, weak pelvic floor muscles
- Bio-feedback exercises improve motor function of sysy muscles and perineum muscles
Neuro-stimulation exercises improve the functioning of the muscles of the bladder, urethra sysing muscles and the conditioning of bladder activity – s lateral muscles, improve sensory disorders, relieve bladder pain
3.3. Nutrition and other care
- Drink plenty of water: Should drink about 2l of water / day, do not use water with gas, should use more orange juice, lemon
- Increased use of foods rich in Vitamin C
- Use the drug prescribed by BS, do not stop the drug voluntarily, stop the urinary order without the consent of the doctor
- Record urination, check urine and urinary system regularly as in dinhed, measure uroly uroly regularly with patients with in dinh
Share99 International Health Hub is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern technology equipment system but also stands out for comprehensive and professional medical examination, consultation and treatment services; civilized, polite, safe and sterilized medical examination and treatment space.
Customers can directly go to Share99 Health System nationwide for examination or contact the hotline here for assistance.
- First aid for spinal injury victims
- Learn about Brown-Séquard syndrome
- Straighten the hunchback 45 degrees with the operation "3 in 1"