SCI Health

SCI and Your Bladder

When you have a spinal cord injury, you will have a neurogenic bladder (definition: the bladder's response to a spinal cord injury). Many will no longer be able to feel when they need to use the bathroom and the bladder may spasm (definition: a sudden involuntary muscular contraction or convulsive movement). Since many can't feel the urge, catheterizing the bladder to empty it is necessary, either intermittently or with an indwelling catheter. Some however can feel the urge to urinate because of an incomplete injury, but still need to use a catheter because of no muscle control.

Catheterizing means inserting a plastic tube into your bladder to empty it. There are many different verieties of catheters. Your level of your injury determines the catheter you will use, and overtime the style of catheter you use may change.

Some catheters stay in permanently, with a tube connected to it and draining urine into a bag that's strapped to your leg (usually hidden under your clothes). 80% of quadriplegics manage their bladder this way since they have limited hand mobility. The catheter may even go into a special hole created by a surgeon on the side of the abdomen. This is called a supra pubic catheter (definition: a suprapubic catheter tube that drains urine from your bladder. It is inserted into your bladder through a small hole in your belly) and many will get this instead because it leaves their pubic area alone.

If you can move your hands, you can catheterize on your own by undressing yourself and inserting the tube into your urethra (definition: the external opening to your bladder), either while sitting on a toilet or in bed. Men have it easier than women when it comes to this, which is explained below.

Also, it's important to keep up good hygiene when catheterizing. UTI's otherwise known as urinary tract infections (definition: an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra) happens to a lot of people with spinal cord injuries, and they are considered a very serious condition. The reason why is because antibiotics (definition: a medicine, such as penicillin or its derivatives, that inhibits the growth of or destroys microorganisms) used to make them go away works, but the bacteria can become used to antibiotics and they will no longer work. Hot water and soap are key every time you catheterize.

Below are the different catheter options for both men and women with spinal cord injuries.

Men

Because of how a man's body is built, they can catheterize much easier than women. While sitting in their wheelchair, many men can just unzip their pants, even tetraplegics (definition: paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso) can insert the catheter and drain their bladder into a plastic bag or bottle (that's attached to the catheter) while sitting.

For men with little arm movement, they will usually have a super pubic catheter (described above). Others may get the Mitroffanoff procedure (definition: a small tunnel from the bladder to the outside of the body used to empty the bladder with a catheter (definition: a small flexible tube that is put into the bladder through the Mitroffanoff).

This is popular with women with spinal cord injuries, but it requires surgery. After you're healed (about a month), a new drainage hole called a stoma (an artificial opening in the body) for the bladder is created and placed in either the belly button or on the side of the abdomen so the individual can insert the catheterize from this hole.

Women

Women with spinal cord injuries have to be a bit more careful about their bladder management options after their injury. Many quadriplegic females decide to get the supra pubic catheter (described above), while others will get the Mitroffanoff procedure (also described above). 

Many females like to get the Mitroffanoff because it allows them to wear dresses and skirts more easily. The surgery however is quite serious and requires a lot of planning. For many the idea of rearranging their insides so they can go to the bathroom easier may sound scary, but it can be reversed in case a cure for spinal cord injuries is found.

And for lady paraplegics who can use their arms and fingers, they usually choose to insert a catheter into their urethra on their own and don't get the surgery, since they can undress themselves and get to their urethra more easily. Many will do this over the toilet by moving themselves from their wheelchair to the toilet itself.

The bladder is one of the most affected parts of the body after a spinal cord injury. It's important to stay on top of it at all times to avoid any infections. When you take care of your bladder properly - drink enough water and empty it when needed - you should have a healthy bladder for years to come.

Please watch the video below to learn more about what a neurogenic bladder, and then read the Takeaway Points below.

Video:  What is Neurogenic Bladder?

Takeaway Points:

  • How a bladder responds to an injury varies for each injury
  • People with SCI have a higher rate of having UTI's
  • Our bladders become neur0genic after an injury
  • Men and female quads like to get the suprapubic catheter
  • Other quads will get the Mitroffanoff procedure
  • Antibiotics are used to treat UTIs

Helpful Links:

Bladder Care and Management (PDF) - UAB-SCIMS - http://images.main.uab.edu/spinalcord/SCI%20Infosheets%20in%20PDF/Bladder%20Care%20and%20Management.pdf