When people see someone in a wheelchair, they typically notice the obvious fact first: this person can’t walk. But restricted mobility is just one issue that people with Spinal Cord Injury (SCI) must face. In fact, problems with the bladder and bowel are commonly ranked as being bigger obstacles than an inability to walk.
What is the Spinal Cord?
Positioned in a fluid-filled canal in the backbone, the spinal cord is about as thick as a finger and extremely delicate. Its role in the human body is to send and receive neurological signals, allowing us to control various muscles – including those needed to empty the bladder and bowel. When a spinal injury occurs, these signals can be interrupted.
Types of Spinal Cord Injuries
The higher that an injury occurs on the spinal cord, the more muscles that are affected. In the case of paraplegia, the spinal cord is so damaged that the legs are impacted. For those with tetraplegia, both the arms and legs are affected.
When someone has complete spinal cord damage, it means that the spinal cord has been entirely cut off and no signal can travel along it. With this type of damage, all feeling and ability to move is absent below the point of injury. If the damage to the spinal cord is incomplete, there is a loss in muscle control but some signals will still go through. It is relatively common for those with incomplete damage to still have some dexterity in the hands, allowing them to self-catheterize.
An injury to the spinal cord may cause detrusor-sphincter dyssynergia, a condition where the bladder contracts but the sphincter remains closed.
Having the bladder and sphincter to work against each other can lead to dangerous results. As high pressure builds up in the bladder, urine is forced back up to the kidneys. Not only can this cause kidney damage, but it also increases the risk of infection and incontinence. A first line treatment for detrusor-sphincter dyssynergia is to reduce pressure with pharmaceuticals and completely empty the bladder through Intermittent Catheterization (IC).
With an injury occurring lower on your spinal cord, muscle tone in the bladder and sphincter can be lost. A complete injury prevents the bladder from contracting, but incomplete lesions are more common. Since incomplete lesions only affect some nerve fibers, the urinary system may still partially function.
A low spinal cord injury results in retention or incomplete emptying, urinary tract infections and (overflow) incontinence. Worth mentioning, recent studies indicate that some of those who lose control of their bladder following an injury may eventually regain function.
SCI Effects on the Bladder
Simply put, the higher the injury is located, the more serious it may be for your bladder condition. This is due to loss of steering and control of urination from the brain, and its centers. Self-catheterization can help those who have sustained a SCI by completely emptying the bladder and protecting the urinary system from long-term complications.
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