A BEHOVIRAL THERAPY IN TREATMENT OF NEUROGENIC BLADDER
Introduction: This paper is a literature review on the Neurogenic Bladder and ways of treatment in behavioral psychotherapy approach. Literature review: The neurogenic bladder constitutes loss of normal function of the bladder caused by damage to a portion of the nervous system. Its origin may be related to altered innervation of the bladder wall or sphincter, both by congenital lesions, or acquired lesions such as tumors or trauma. (Riella, 2008). The storage and periodic urine elimination depends on the coordinate activity of two functional units of lower urinary tract, the bladder is the outflow tract, the bladder neck, urethra and urethral sphincter and the timing of their structures is mediated by a complex neurological control located in the brain, the bridge reticular substance, in the cerebellum, spinal cord and peripheral ganglia, with the participation of several neurotransmitters and neuromodulators. (Goldberg, SAND, 2002). There are three therapeutic available modalities for treatment: pharmacological; behavioral therapy, and surgery. A combination of the first two is effective in most patients. Behavioral interventions such as limiting consumption of bladder irritants, suppression techniques and pelvic floor exercises are part of the therapeutic strategies. (Dmochowski, 2003). The International Consultation on Incontinence (Abrams, 2010) recommends behavioral therapy as 1st-line approach to incontinence, which aims to change the attitude of the individual and their interaction with the environment. Presents several acting components, which are: Education; Dietary modification and lifestyle; Bladder training; Pelvic floor muscle therapy and Auto monitoring with voiding diary. Conclusion: Neurogenic bladder is a neurological disorder that causes serious impairment to physical, emotional and social health of its patients. The recommended treatment is a combination of pharmacotherapy with behavioral therapy that aims to train hygiene behaviors and autonomy that contribute to the patients welfare.
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