A spinal cord injury, regardless of its level, mostly impairs the bladder control. Nerves located at the bottom end of the spine control proper function of organs, including the bladder. When an injury happens, those nerves are disconnected from the brain and they do not receive its messages. Consequently, neither do the bladder muscles.
The brain, as the central system, does not control the bladder function anymore and the urinary incontinence develops. This bladder disorder is also called the neurogenic bladder.
The neurogenic bladder can be a consequence of an illness, congenital brain defects, spinal cord injuries or spina bifida.
Although, if we develop the neurogenic bladder, we will not be able to control our bladder as we used to before the injury, there are various medical aids and techniques available in order to solve this problem and have the ability to regularly empty the bladder.
There are two types of the neurogenic bladder that compromise the normal bladder function:
- when the bladder is not active enough, it loses its ability to contract and empty itself completely
- when the bladder is overly active (spastic), it is a subject of frequent and unpredictable urination caused by involuntary nervous reflexes (spasms) typical for spinal cord injuries.
During the stage of shock and denial (after the injury), the spastic bladder can last for months. It loses its elasticity in the process and one can experience urine leakage as a symptom of the overflow incontinence. This phase is followed by an overly active phase of involuntary filling and emptying of the bladder. When this happens, a normal function of filling and emptying of kidneys is also interrupted and that can compromise the healthy function of kidneys. Catheterization is a solution for such medical symptoms.
Frequently asked questions
Spinal cord injuries change the function of the bladder muscles and block the signals the brain sends to the bladder. When the spinal cord is injured, a normal function of urination through relaxation and contraction of the sphincter is disabled. This disorder also has an impact on your ability to determine when the bladder is full.
Depending on the level of the spinal cord injury and the condition of the person suffering from the spinal cord injury, the bladder can be overactive – frequently filled and emptied; or insufficiently active.
A regular catheterization on daily basis is necessary since if the urine is retained in the bladder for too long, bacteria can thrive on it and we risk urinary infections. Infections are a possible threat we should be especially aware of. It is advisable to start a treatment of antibiotics when we notice the first signs of an infection since it can cause sepsis and hospitalization.
Our tendency to retain the urine for too long and the over flooded bladder can cause a kidney damage. This is why we should follow instructions of health professionals about the healthiest way of bladder movements.
We should pay attention to pressure wounds as a consequence of the usage of adult diapers and condom catheters since they expose the skin to urine and make her more sensitive. That is why a high quality and reliable products specially designed to retain higher volumes of fluid while also trapping moisture inside away from the skin are recommended.
Also, aside from a recommended daily personal hygiene, in order to prevent possible urinary tract infections, people with such medical symptoms should drink high amounts of liquid, preferably water since it flushes bacteria out of the body and prevents their retention and thriving in the urinary tract. The best indicator that shows us that we consume enough liquid is almost transparent or light yellow and clear urine. Prior to each self-catheterization, we should drink a glass and a half of water. And, of course, prior to each self-catheterization, we should wash our hands since catheterization in an environment like the pelvic floor can be a risk factor for infections.
Cranberry juice or supplements are also recommended against infections since they also wash away bacteria and prevent their thriving.
Some types of this defect, like hydrocephalus, are more serious, more visible and demand a more complex treatment approach, but so-called mild problems like urinary incontinence and obstipation should also not be neglected.
Regular emptying of the bladder, due to a lack of activity, is extremely important for children and adults with spina bifida in order to prevent kidney disorders and urinary infections. The same approach should be applied for bowel movements.
A proper care for these bodily functions is directly related to the life span and the quality of living.
Regular medical check-ups, at least once a year, careful catheterization with high-quality products and proper regular hygiene significantly reduce risks of infections. However, if we notice any of the symptoms mentioned below, we should contact our medical doctor immediately since urinary tract infections can be life-threatening if not diagnosed and treated.
Some of the symptoms you should pay attention to are cloudy urine with an intense and unpleasant smell, a high temperature with fever, nausea, headaches and intense spasms. We can also feel discomfort in the lower back as well as in the abdomen. It is possible that some people will develop symptoms that are not included here. So, in case you notice anything suspicious, contact your medical doctor immediately.