Bladder Dysfunction

Irritability of the bladder can caused by local disease which directly stimulates the destrusor muscle or heightens the sensitivity of the stretch receptors in the bladder wall.The muscle then becomes so insensitive that the central nervous system may fail to control it,producing detrusor instability.
Alternatively,irritability and/or instability may be the result of a primary error in the nervous inhibition of an essentially normal bladder musle.
Irrespective of the mechanism behind detrusor irritability,the sphincter mechanism is normal and the fault lies in the bladder which becomes intolerant of even moderate amonts of fluid.The clinical effects are frequency,urgency and nocturis.If detrusor instability develops then either urge incontinence or enuresis may occur.Moreover,if the bladder wall goes into spasm,pain and dysuria are added.

Causes of bladder dysfunction:
Polyuria:
A complaint of frequency diurnal and/or nocturnal is sometimes explaind morely by an increased excretion of urine.This can be caused by:
-a cold environment,causing a reduction in the excretion of fluid by the body surface.
-a habit of drinking large quantities of tea,coffee or other fluid.This habit can have a background of nervous tension,loneliness and unhappiness.
-pregnancy (except in the latest weeks).
-diabetes.
-impaired renal function resulting in the output of large quantities of unconcentrated urine.Old age acts mainly by this mechanism.
-insomnia.

Mechanical Factors:
-displacement of the bladder
pelvic and lower abdominal tumours
-adhesions and bands in the uterovesical pouch
-incomplete emptying of the bladder
-diseases of organs adjacent to the trigone
-diseases of renal pelvis and ureter
-diseases of the bladder.