From impact on your bladder to lifestyle

Spinal cord injuries: what to expect

The spine is a vital communication highway that makes it possible for signals to be transmitted all around our body. Damage to the spinal cord can disrupt that communication, affecting the functioning of our bodies, routines and lifestyles.  One common outcome of SCIs is disruption to our body’s capacity to properly communicate with the bladder, leading to some level of bladder dysfunction^[15]. 

What does my spinal cord have to do with my bladder?

80% of people experience a lack of bladder control after spinal cord injuries (SCIs)^[16]. This is because the spinal cord plays a pivotal role in carrying signals that control your bladder muscles from your brain. As one example, when your bladder is full, stretch receptors in its walls send signals to the spinal cord, which then processes this information and initiates the reflex to empty the bladder.

Can any spinal cord injury influence urinary continence?

The location and severity of an injury to the spine will most likely determine whether or not, and how much, it affects your bladder. The nerves that control the bladder are located in the sacral region of the spinal cord, which is in the lower back. Injuries to the thoracic and lumbar regions, higher up the back - above T12 - are more likely to cause bladder dysfunction as messages to and from the bladder need to pass through here before reaching the sacral region^[17].

Are there different types of bladder dysfunction after a spinal cord injury?

The short answer is, yes. People experience varying levels of bladder dysfunction after an SCI, each dependent on the location and severity of the injury. 

• Reflexic Bladder is usually associated with injuries at or above the sixth thoracic vertebra (T6), leading to reflexive bladder emptying^[18].
• Areflexic Flaccid Bladder, common in injuries below T6, is a lack of both voluntary and involuntary bladder control due to an underactive detrusor muscle and weak sphincters^[19].
• Neurogenic Bladder is a term that covers a range of bladder dysfunctions resulting from a spectrum of neurological conditions, including spinal cord injuries^[20]. 

After a spinal cord injury, how can you treat urinary incontinence?

Managing bladder control issues after a SCI can feel overwhelming, but there are effective strategies to help individuals regain a sense of autonomy and control that improve their quality of life.

Perhaps the most common approach is catheterisation. This is where the bladder is emptied using a catheter, which can be self-administered or with assistance by a caregiver^[21]. In some instances the catheter is used to drain the bladder, and then removed rather than being left in, which is known as intermittent catheterisation. Fortunately, intermittent catheters are as varied as we are, and so you’ll be able to find ones that are right for your size and level of mobility.

In summary

When it comes to bladder control, while the disruption SCIs can bring to this essential part of our daily lives can feel overwhelming and demoralising, there is an amazing array of options out there to help, all backed up by a huge wealth of information and teams ready to guide you on your path to happier, more confident bladder management.

To give you an idea of how intermittent catheterisation can help alleviate some of the impact of a spinal cord injury, you can check out some catheter options here. It could be the information you, or someone you know, really need to get your journey started.

[15] NIH. (2023, January 20) Spinal Cord Injury. https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury

[16] Leslie, S. W., Tadi, P. & Tayyeb, M. (2023, July 4). Neurogenic Bladder and Neurogenic Lower Urinary Tract Dysfunction. National Centre for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK560617/

[17] National Institute of Neurological Disorders and Stroke. (2023, January 23)). Spinal Cord Injury.  https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury

[18] Shepherd Centre. (n. d.) Bladder Function After SCI. My Shepherd Connection. https://www.myshepherdconnection.org/sci/bladder-care/function-after-sci

[19] Hsieh J, Ethans K, Benton B, Burns A, Welk B, Loh E, McIntyre A, Teasell R (2020). Bladder Management Following Spinal Cord Injury. In Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Noonan VK, Loh E, Sproule S, McIntyre A, Queree M. (editors). Spinal Cord Injury Research Evidence. Version 7.0: p. 1-274.

[20] University of Michigan (n. d.) Neurogenic Bladder. University of Michigan Health. https://www.uofmhealth.org/conditions-treatments/adult-urology/neurogenic-bladder

[21] Convatec (n. d.) Why Do I need to use an intermittent catheter. Gentlecath. https://www.gentlecath.com/au/answers/why-do-i-need-to-use-an-intermittent-catheter/