Bladder and bowel issues - Coloplast South Africa
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Introduction

How Spinal Cord Injuries affect the bladder and bowel

Bladder and bowel issues are a common consequence of spinal cord injury. However, with the right routine and the right products, you can take control and improve your quality of life. Consequences of Spinal Cord Injury
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Consequences of Spinal Cord Injury

About 80% of people with a Spinal Cord Injury (SCI) will experience some or even a total loss of bladder control. The predominant symptom of this is an inability to pass urine, though urine leakage is also very common. In addition, 34% of people with SCI have bowel issues to a degree that affects their daily life.

It’s important to deal with these issues effectively so that you avoid troublesome complications and to ensure they have the least possible impact on your day-to-day life. Here are some solutions for the problems you might experience:

Inability to empty the bladder

Clean intermittent catheterisation is an effective bladder management technique based on the regular and complete emptying of the bladder by using a catheter.

 

Leaking urine

Urisheaths are an effective way to collect leaking urine for boys and men. The sheath is worn over the penis and is connected to a urinebag fastened to the leg.

 

 

Spinal Cord Injury - the basics

Spinal cord injuries (SCI) usually result in loss of sensation and movement or permanent disability below the site of injury. They can be split into four groups, depending on the level of injury:

  • Complete tetraplegic (quadriplegic): Total loss of movement and sensation in all four limbs (i.e., arms and legs)
  • Incomplete tetraplegic (quadriplegic):  All four limbs are affected, however some sensation and limited voluntary muscle control remains
  • Complete paraplegic: Loss of movement and sensation in the lower part of the body
  • Incomplete paraplegic: Only the lower part of the body is affected, however some sensation and limited voluntary muscle control remains
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Good to know

Frequently asked questions

Here you will find answers to the most common questions relating to spinal cord injuries and bladder and bowels. FAQs on SCI and bladder
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FAQs on SCI and bladder

Why does an SCI cause bladder issues?

The bladder, which stores urine, is controlled by the nervous system. When you have a spinal cord injury, it is likely that the nerves controlling your bladder are damaged and, as a result, bladder function is affected. Some people find that they need to urinate more frequently or urgently, some experience urine leakage, whereas others experience difficulty emptying the bladder.

 

How can bladder issues affect my lifestyle?

If your bladder is not emptied regularly, it can cause infections. These start in the bladder but can move back to the kidneys and cause serious renal damage. Even small amounts of urine left in the bladder can cause infections.


Alternatively, if you cannot control the urge to urinate, you may experience leakage. This can lead to bad odours that cause embarrassment. Consequently, it is important to care for your bladder in a way that has the least impact on your daily life.

 

What can I do to deal with my bladder issues?

There are a number of methods and products available to help manage your bladder issues. These include catheters, urisheaths (for men) and absorbent products. 
 

What is a catheter?

A catheter can be used to ensure the bladder is completely emptied. It’s a slim, flexible tube that is inserted into the bladder through the urethra and which enables the urine to drain.

 

Why is it important to empty my bladder?

Not emptying your bladder regularly can lead to infections. These start in the bladder but can move back to the kidneys and cause serious renal damage. Even small amounts of urine left in the bladder can cause infections.

 

Can I just empty my bladder in the morning and in the evening?

No. You should follow the schedule your doctor has given you. As a rule, the bladder should be emptied at least 4–6 times a day.

 

Can I drink less so that I don’t have to empty my bladder so often?

No. It is very important that you drink enough. This keeps the urinary system clean and healthy.

 

What if the urine looks cloudy or dark and smells funny?

You may have an infection. Talk to your doctor or nurse.

 

Does it hurt to catheterise?

No. You might feel some pressure when the catheter goes in. If you experience discomfort or if it is difficult to slide in the catheter, take a short break. Try to relax by taking a deep breath or by coughing. Talk to your doctor or nurse if you find it painful.

 

What if I get frequent urinary tract infections?

Using an intermittent catheter does increase the risk of urinary tract infections. However, compared to other catheter types such as permanent (indwelling) catheters, intermittent catheters are less likely to cause urinary tract infections. There are ways to reduce the risk of urinary tract infections:

  • Drink more fluid during the day – the principle here is simply to wash out the urinary tract, providing you continue to catheterise
  • Make sure that the bladder is fully emptied every time you catheterise
  • Increase the number of daily catheterisations
  • Make sure you have clean hands and equipment when doing the catheterisation
  • Reassess your intermittent catheterisation technique (insert link to animation) 

 

What should I do if I’m still leaking urine?

Urine leakage may occur for different reasons: 

  • A urinary tract infection may cause urine leakage, and you should contact your doctor if you suspect you have one. The typical symptoms to be aware of are:
    • Dark coloured and strong-smelling urine
    • Cloudy urine
    • Blood in the urine
    • Fever/sweating
    • Bladder spasms
    • Increased muscle contractions in your leg 
  • Leakage may also occur because you don’t catheterise often enough (less than four times a day). You should:
    • Consider catheterising more frequently to avoid the bladder pressure from building
    • Make sure your bladder is fully emptied every time you catheterise
    • Reassess you intermittent catheterisation technique
    • If you are catheterising more than seven times per day and are still having problems with urine leakage, you may wish to consult your doctor
  • You may leak because you have involuntary bladder spasms/contractions (not caused by a UTI). You should:
    • Talk to your doctor about the possibility of medication to relax your bladder 

If the leakage mainly occurs doing physical exercise, you should consider catheterising before you start to exercise. 

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Urinary tract infections

When using catheters it is normal to experience urinary tract infections. Some people get them more often than others, but by following a few simple routines you can reduce the risk. Avoiding and preventing urinary tract infections
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Headline text

A urinary tract infection is an infection in the urinary tract, the series of organs that make up the urinary system. The presence of bacteria in the urinary tract is quite common and not necessarily a problem. If, however, the bacteria grow and multiply to a certain level, they may cause an infection of the urinary tract that needs treatment.

Symptoms of urinary tract infections

Symptoms of a urinary tract infection vary and may be subtle. They include:

  • Dark-coloured and strong-smelling urine
  • Cloudy urine
  • Blood in the urine
  • Fever/sweating
  • Bladder spasms
  • Increased muscle contractions in your leg

If you experience any of the symptoms listed, you should consult your nurse or doctor.

Avoiding urinary tract infections

While there is no definite solution to avoiding urinary tract infections, there are a number

of simple precautions that can help you prevent and sidestep recurrent infections: 

  • Generous intake of fluids – at least 1.5 litres a day
  • Good personal hygiene – especially when you catheterise
  • Catheterisation routines – complete emptying the bladder regularly
  • Healthy digestion – a good bowel routine may reduce the risk of urinary tract infections

Changing the type of catheter you use can also help reduce the number of urinary tract infections you experience.

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Tips, tools and guides

Self-catherisation guides

Underneath you can find video guides for catherisation

Recommended products

EasiCath® A safe and easy to use intermittent catheter

EasiCath® A safe and easy to use intermittent catheter

Patients with neurogenic bladder dysfunction need a safe method that not only fully empties the bladder but also lowers the risk of urinary tract infections. EasiCath has been designed to meet that need. Learn more about Easicath
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Easicath®

References

1 Cindolo L, Palmieri EA, Autorino R, Sazano L, Atieri V., Urol Int 2004; 73: 19-22

2 “Coated catheters for intermittent catherization: Smooth or sticky?”; Fader M, Moore KN, Cottenden AMPettersson L, Brooks R, Malone-Lee J. BJU Int 2001;88(4):373-377

3 EAU guideline on neurogenic lower urinary tract dysfunction (2012)

4 “Effect of bladder management on urological complications in spinal cord injured patients”;Weld K et al. J. Urol 2000:173;768-772

The benefits of EasiCath

  •  Minimises the risk of urinary tract infections compared to uncoated catheters1
  •  A single use, sterile intermittent catheter for good catheterisation hygiene
  •  Reduces the risk of urethral damage2
  • A hydrophilic coating for easy use

 

Clinical evidence proves the benefits of EasiCathas a preferred method of bladder emptying

  • EasiCath significantly decreases the number of urinarytract infections compared to uncoated catheters1, andhelps ensure no residual urine is left in the bladder
  • EasiCath has a smooth and uniform hydrophiliccoating that allows for easier catheter usage,thereby minimising the risk of urethral micro damagecompared to uncoated catheters and othertraditionally hydrophilic coated catheters2
  • Results in lower risk of urological complicationscompared to alternative bladder emptying methods3,4
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