Micturition Disorders Flashcards
What nerve is associated with “voiding” urine?
Pelvic n. (S1-S3)
also has other sensory innervation to bladder
What nerve is associated with the somatic striated muscle component of the bladder?
Pudendal n. (S1-S3)
What nerve is associated with urine storage?
Hypogastric n.
K9: L1-L4// Fel: L2-L5
How do we treat UMN Bladder AKA Detrusor Areflexia with Sphincter Hyperreflexia?
Baclofen (antispasmodic; inhibits nts, mm.relaxant)
Patients presenting with IVDD and/or neck trauma in addition to a small-ish bladder that is super distended and difficult to express. What are we thinking is the micturition disorder?
UMN Bladder AKA detrusor areflexia with sphincter hyperreflexia
In the case of LMN bladder (AKA detrusor areflexia and sphincter areflexia), why do we see a large, easily expressed bladder/constantly dribbling patient?
Because the damage to the nerve has compromised the IUS
How do we treat LMN bladders? What other factors do we need to consider??
Compress bladder 3-4 times a day.
Bethanecol: parasympatholytic—>increase contraction on the bladder
*these patients are predisposed to UTIs
How would we treat Detrusor-sphincter reflex dyssynergia in patients presenting with stranguria and we suspect a brain or spinal cord lesion?
Alpha-adrenergic blockers (phenoxybenzamine, prazosin, tamulosin)
What is “Urge Incontinence”/ AKA Detrusor Instability/Detrusor Hyperreflexia?
The detrusor suddenly contracts while the urine is being stored (while the bladder is not totally distended) so as the bladder is filing up, prematurely, you get contraction of the Detrusor m.and that results in urination. Low compliance of detrusor m… confirm by cystometrography
What are clinical signs of Urge Incontinence?
How do we treat?
Pollakiuria, stranguria, and dysuria
Use anticholinergic (stop the PSNS to allow for filling up of the bladder) - oxybutynin, imipramine, or dicyclomine
Which fiber types control continence?
Type I smooth muscle (decrease susbstantially after OVH)
T or F: Studies show spaying early and incontinence were not found to have a significant association, however tail docked bitches were 3.8 times more likely to be incontinent than undocked bitches.
True
