Bladder Management

How the bladder normally works?

The bladder acts as a reservoir for urine and is able to hold up to 400mls or so, without discomfort. The bladder’s task is to store the urine and expel it at a socially acceptable time. To assist with this task, a muscle at the bladder outlet (the sphincter) normally keeps the opening closed.

Usually when the bladder is getting full a message is sent to the brain via the spinal cord for a conscious decision. When it is convenient to pass urine the brain sends a message back down the spinal cord to the bladder. This initiates the bladder and sphincter muscles to contract and empty the bladder

How does a spinal cord injury affect the bladder?

In nearly all cases of spinal cord injury there will be some impact on your bladder function:

  • The messages that travel up and down the spinal cord to and from the bladder will be interrupted, so you will most likely lose voluntary control over your bladder.
  • You may also be unable to empty your bladder completely, which can lead to problems because the urine that is left inside your bladder can become infected and could cause bladder stones.

A new way must be found to empty the bladder safety and effectively.

What are the main types of bladder management?

The method of bladder management that is chosen for you is very individualised, and depends on factors such as your hand function  (whether you can hold a catheter), level of injury (whether you can transfer onto a toilet), your bladder type, your age, your personal preference and lifestyle.

Main types include:

  • Tapping and expressing
  • Indwelling catheter
  • Suprapubic catheter
  • Intermittent clean self-catheterisation
  • Free drainage

How can I keep my urinary system healthy?

The purpose of all bladder management is to keep the urinary system healthy and protect the kidneys from damage.  You can do this by:

  • Emptying your bladder regularly and making sure that there is as little urine as possible left in your bladder, to prevent urinary tract infections.
  • Maintaining good personal hygiene and skin care, and washing your hands before and after bladder care to prevent any spread of germs.
  • Checking you urine regularly for signs of infection.
  • Taking your bladder medication as prescribed by your doctor.

What are signs and symptoms of a Urinary Tract Infection?

  • Fever
  • Feeling unwell
  • Sweating
  • Shivering
  • Leaking in between intermittent catherisations
  • Pain or discomfort when passing urine
  • Increased spasms
  • Smelly urine
  • Urine may be cloudy, contain blood or debris

What do I do if I think I have a Urinary Tract Infection?

  • Drink plenty of water (at least 3 litres a day).
  • Empty your drainage bag, or perform self-catheterisations more frequently.
  • Take a urine sample to your local doctor.
  • Be aware that you may be more susceptible to pressure sores when sick – check your skin regularly.