Living With a Spinal Cord Injury-Bladder Care

Living With a Spinal Cord Injury-Bladder Care Good bladder management can improve your quality of life by preventing bladder problems, which is one of the biggest concerns for people who have spinal cord injuries (SCIs).

Normally, the kidneys filter waste products and water from the blood to form urine, which is stored in the bladder. When the bladder is full, a message is sent from the bladder to the brain. The brain sends a message back to the bladder to squeeze the bladder muscle and relax the sphincter muscles that control the flow of urine. After the bladder starts to empty, it normally empties all of the urine.

After an SCI, the kidneys usually continue to filter waste, and urine is stored in the bladder. But messages may not be able to move between your bladder and sphincter muscles and your brain. This can result in the:

• Inability to store urine. You cannot control when your bladder empties (reflex incontinence). This is known as reflex or spastic bladder.
• Inability to empty the bladder. Your bladder is full, but you can't empty it. It stretches as it continues to fill with urine, which can cause damage to the bladder and kidneys. This is known as a flaccid bladder.

Not taking good care of your bladder can lead to urinary tract infections (UTIs), kidney and bladder problems, sepsis (a bloodstream infection), and, in rare cases, kidney failure. For information on testing for, treating, and preventing UTIs, see the topic Urinary Tract Infections in Teens and Adults.

Bladder programs

A bladder management program lets you or a caregiver empty your bladder when it is easy for you and helps you avoid bladder accidents and prevent UTIs. You and your rehabilitation team decide which bladder management program is best for you. You need to consider where your spinal cord is injured and how it has affected your bladder function. You also need to consider your lifestyle, how likely you are to get bladder infections, and whether you or a caregiver is able to use a catheter.

The most important things in bladder management are monitoring the amount of fluids you drink, following a regular schedule for emptying your bladder, and being sure that you empty your bladder completely. Your rehab team will help you set up a schedule based on your needs and the amount of fluids you typically drink.

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