When does the urinary system malfunction?

There are different reasons why the bladder may not be able to store or empty urine. Most frequently illness, injury or aging damage the function of the urinary system

Voiding disorder

Voiding disorder can be based on physiological problems, e.g. due to a urethral stricture, or on neurogenic problems caused by paraplegia, spina bifida or multiple sclerosis.

In a neurogenic voiding disorder, the nerves between the bladder and the brain are impaired or completely interrupted. With this damaged information transfer the brain is no longer able to control the bladder muscle and the sphincter.

Voiding disorders occur as

• storage problems – the bladder cannot hold/retain the urine, consequently there is an unintentional loss of urine, which is called urinary incontinence
• emptying problems – the bladder cannot be emptied intentionally, which is called urinary retention
• incomplete voiding (residual urine) – after voiding a small amount of urine remains in the bladder and can lead, if untreated, to urinary tract infection
• combinations of incontinence, retention and residual urine

If you are diagnosed with a voiding disorder, the doctor will often advise you to perform intermittent catheterisation.

What happens, when we feel the need to empty our bladder?

When the bladder needs to be emptied the nerves in the bladder send a signal to the brain and we feel an urge to urinate. Once we reach the toilet, our brain sends a message to the large bladder muscle, the detrusor, to contract making the urine leave the bladder. At the same time, the brain tells the sphincter muscle, which keeps the bladder sealed, and the pelvic floor muscles to relax. The process of urination starts. When we have finished urinating, the sphincter muscle contracts again and the bladder muscle relaxes and stops squeezing. Then the bladder is ready to fill up again.

Generally we empty our bladder several times a day. In some conditions the nerve impulses to the brain do not function or are damaged so that we are unable to control the bladder. If the urination process is malfunctioning, we call it “voiding disorder”.