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How does spinal cord injury affect bladder control?


Following a spinal cord injury, signals between the bladder and the brain may not work properly. As a result, the bladder cannot tell your brain that the bladder is full and the brain cannot allow you to voluntarily empty your bladder. The changes that may occur after a spinal cord injury are in the way that your bladder empties. Depending on your injury, there are ways that your body will react.

Depending on the type of spinal cord injury, two types of bladder dysfunction can occur:

• The bladder tends to hold less urine than it did before the injury, and the bladder muscles may spasm involuntarily, resulting in frequent and small urinations.

• The bladder loses its ability to contract and is stretched out, allowing more urine to accumulate, which then

causes the bladder to “overflow” or leak.

Bladder Management Following a Spinal Cord Injury

After a spinal cord injury, the way your bladder works may change. The type of change depends on the level and extent (or completeness) of your injury.

You want to PREVENT:

  • Urinary Tract Infections.

  • Avoid kidney problems: Damaged kidneys can lose their ability to filter fluids and waste from your body. This can lead to kidney failure.

  • Autonomic Dysreflexia: An abnormally high blood pressure response that can develop when the bladder or bowel becomes overfull. It is a serious problem. If you feel that an overfull bladder is the cause, empty your bladder.

You want TO:

  • Keep your kidneys healthy. Prevent urinary tract infections.

  • Prevent high blood pressure response when the bladder or bowel becomes overfull.

  • Ensure you stay dry. Keep skin clean and healthy.

Bladder Routines

A good way to avoid bladder problems is to follow a bladder routine or toileting program. You should:

  • drink lots of fluids

  • catheterize yourself regularly

  • use good clean technique

Common Urinary Incontinence Conditions:

OVERACTIVE BLADDER When you feel the need to go and go right NOW, you may be dealing with an Overactive Bladder. If you cannot control the urge and leakage occurs, that is what makes it incontinence.

URINARY RETENTION In mild cases, urinary retention makes it difficult to start urination and the flow is weak. Once finished you often feel the need to go again because the bladder isn’t fully emptied. In more acute cases, the lower belly becomes distended causing great discomfort and pain. Despite the urge to go, urination is not possible.

MIXED INCONTINENCE Mixed Incontinence is a combination of stress incontinence, including muscle and sphincter related issues, and urgency incontinence like those mentioned above. Usually one symptom is more severe than the other and that directly affects what methods will be most effective in treatment.

STRESS URINARY INCONTINENCE A problem that affects both men and women, Stress urinary incontinence (SUI) occurs because of weak pelvic floor muscles and/or a deficient urethral sphincter. This weakness can cause the bladder to leak during exercise, coughing, sneezing, laughing, or any body movement that puts pressure on the bladder. SUI often shows up after childbirth and menopause in women while prostate cancer treatment, such as radical prostatectomy, can trigger it in men.

If you suffer from urinary incontinence due to a spinal cord injury contact your doctor today to discuss treatment options.

To schedule an appointment at Pinehurst Neurology call (910) 295-6868 or visit our website at www.pinehurstneurology.com.

To learn more visit: American Urological Association: www.urologyhealth.org

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