Exploring the link between spinal cord injury and the bladder.

What is a Spinal Cord Injury?

A Spinal Cord Injury (SCI) relates to damage to the spinal cord that causes temporary or permanent changes in its function. Causes can include neurological illness (ie Multiple Sclerosis, spinal cord tumours and osteoporosis) congenital defects or infection (non-traumatic) or through traumatic injuries, such as falls, sporting injuries and road traffic accidents.

What are the types of injury?

Spinal injuries are broadly classified as complete or incomplete. Complete injury is where there is no movement or feeling below the level of injury and incomplete injury is where there is a degree of movement or feeling below the site of injury.

How does a Spinal Cord Injury affect your daily life?

Sustaining a spinal cord injury can have a profound impact on your life, both physically and mentally. Physically, most people with a spinal cord injury will experience some of the following, to some extent:

• Loss of movement in legs, arms, hands and/or arms
• Loss of sensation and feeling in parts of the body
• Loss of bladder and bowel control
• Pain and/or spasms
• Changes in sexual function and sensations

Source: Backup Trust

Beyond the physical challenges you may experience with a spinal cord injury, there are a multitude of emotional challenges you may also face including anxiety, depression, frustration, anger and grief. You may find that it impacts your eating and sleeping habits as well as having an impact on your relationships with others and family life.

How do spinal injuries affect bladder function?

As mentioned above, bladder issues are a physical challenge of living with a spinal cord injury. This is because a spinal cord contains cells that send messages from the brain to other areas of the body and, after injury,  the messages between the bladder and the brain are disrupted.

The bladder challenges you face will depend on the severity and level of injury but include:

• Urine Retention – not being able to fully empty the bladder
• Incontinence/leakage
• Overactive bladder; sudden and urgent need to urinate
• Increased risk of UTIs

During your rehabilitation following your spinal cord injury you will explore techniques to empty your bladder depending on the challenges you are facing. These techniques could include:

An Indwelling Catheter; where a catheter is inserted into the bladder via the urethra and held in place by a small, water-filled balloon. The catheter will continuously drain from the bladder so you will need to have a catheter bag attached to the end of the catheter to collect, store and drain the urine. Sometimes the catheter will be inserted into the bladder via a small surgical insertion in the abdomen – this is called a suprapubic catheter.

Intermittent Catheters; inserting a catheter to drain the bladder every few hours or as recommended by your healthcare professional. ISC is the method of choice for people whose bladder does not contract automatically to void urine after a spinal cord injury.

Sheaths; also known as a condom catheter, are an option for men who experience involuntary leakage of urine following a spinal injury. They are applied over the penis and attach to a catheter bag that collects the urine.

Learning to live with an alternative way of bladder management can initially appear daunting but with support and guidance can be positively incorporated into daily living’

Resources

It is thought that the number of people with spinal cord injuries in the UK has risen to 105,000 with someone becoming paralysed every 2 hours. If you have sustained a spinal injury it is therefore important to know that you are not alone and there is support, help and guidance out there to help you live a full life after injury. The below charities will be a good source of resources:

Backup Trust

Spinal Injuries Association

Bladder and Bowel UK