Bladder Dysfunction

Neuropathic dysfunction of the urinary bladder (also known as neurogenic bladder) in persons with suprasacral spinal lesions of traumatic etiology results in the bladder not functioning as an effective organ for storing urine, and may require various treatments to enable proper voiding. This may include the use of an indwelling urethral catheter, abdominal urinary stoma, augmentation cystoplasty, radio-frequency stimulation of sacral interior nerve roots with surgically implanted electrodes and receiver block, or intravesical capsaicin therapy.

Despite the considerable advances made in urological rehabilitation, persons with bladder dysfunction often develop urinary tract infections (UTIs), and stones of the upper and lower urinary tract, and deterioration of the bladder [1]. Although bladder problems such as UTIs have been declining as a cause of death over the past 25 years, and account for only 2.3% of deaths as reported in the last 5-year analysis of the Model Systems data [2], they still remain one of the most prevalent secondary health conditions reported after spinal cord injury (SCI) [3, 4].

Bladder dysfunction in persons with SCI can be disabling medically, physically, and socially [5]. Issues of incontinence have been reported to be one of the most bothersome or life-limiting conditions after SCI [6, 7]. For instance, implementation of an individualized bowel and bladder management program may be time consuming for both the persons with SCI and caregivers, which results in interpersonal stress in some marital or familial relationships and less time for pleasurable activities [8]. Further, embarrassment about and/or fear of accidents may negatively reinforce avoidance learning, which may decrease the likelihood of an individual engaging in social activities [8]. Bladder and bowel incontinence has been shown to be a significant issue that impacts negatively on sexual function [9, 10]. In addition, UTIs have been shown to be associated with poorer social adjustment [11].

It is not surprising that regaining bladder function is one of the top priorities for persons with SCI [12].

SCI BLADDER RESOURCES

Spinal Cord Essentials – is a patient education initiative which aims help people through rehabilitation following SCI. Below are downloable PDFs of the bladder care handouts.