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
- 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.