Wednesday, May 22, 2024
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Spinal Cord Injuries & Incontinence

| Source: Men’s Liberty Incontinence Blog

spinal_mapThis week’s Wee Answer Wednesday will be squarely focused on incontinence after a spinal cord injury. In the immediate aftermath of a spinal cord injury, there’s a lot to take in. Your life has changed in so many ways that it can be a challenge to get a handle on all the information coming your way. Some problems are bigger than others. In a recent survey of paralyzed veterans, incontinence was identified as the #2 most important issue for those in wheelchairs.

So whether you’re new to the issue or an old hat at managing your incontinence, here are some of the most common incontinence questions men ask after a spinal cord injury.

1. How does a spinal cord injury affect my bladder?

Spinal cord injuries change the way your bladder muscles work and disrupt the messages that are supposed to travel between your bladder and your brain. According at Apparlyzed, when approximately 250 to 300cc of urine are in the bladder, messages from stretch receptors in the bladder are sent through nerves which enter the spinal cord near it’s end in the sacral level of the spine. If the spinal cord is damaged, the action of coordinating the relaxation of the sphincter muscle and contracting the detrusor muscle may be affected, resulting in an inability to urinate properly. In addition to not being able to urinate, the sense of a full bladder may also be lost, as sensory signals from the bladder will not be able to travel to the brain through the damaged spinal cord.

Depending on the level and completeness of your injury, your bladder may empty too often, not frequently enough or in an uncoordinated way. The sphincter muscle may also work incorrectly by not contracting completely or by not relaxing when voiding.

2. Are all individuals with spinal cord injuries incontinent?

There are no absolutes; however, the vast spinal_mapmajority of men in wheelchairs as a result of a spinal cord injury are incontinent of urine. This is because the control of your bladder and bowel is connected to your sacral nerve, which sits towards the base of your spine. In general, the higher your injury, the greater the loss of function you may experience. The vast majority of spinal cord injuries occur above the sacral nerve suggesting there will be some bladder dysfunction.

3. What is spinal shock and how long does it last?

According to the National Association for Continence, spinal shock is the temporary loss of all spinal cord reflexes below the level of injury. This could last from days to weeks. When spinal shock ends, spasticity or stiffness starts to occur below the level that the spinal cord was injured. Spinal shock cannot be prevented and must resolve on its own.

While spinal shock is ongoing, patients are generally catheterized as the bladder will not contract and constant drainage is required. Once spinal shock has passed, doctors will complete several bladder tests to determine function and appropriate bladder management tools.

4. Who should I talk to about my incontinence?

Talk to your doctor!! Incontinence is a normal part of life after a spinal cord injury but there are ways to manage it that can let you be comfortable and independent. Your doctor can discuss the detail of your particular injury and its impact on your bladder as well as suggesting potential management options.

5. What kind of complications should I keep an eye out for when dealing with incontinence?

For individuals with SCI, it is important to monitor your bladder function and your management products for complications. These products are associated with some serious complications that you need to be vigilant to prevent.

Infections: Urine is an excellent medium for bacterial growth. The longer an individual retains urine, the more likely they are to develop a urinary tract infection (UTI). UTIs are extremely common among men who use an indwelling Foley catheter or intermittent catheterization for urinary management. Long term catheterization, bladder irritation and repeated UTIs are also associated with a heightened risk of bladder cancer.

Do not take UTIs lightly. Treatment may require a doctor’s visit and antibiotics. If left untreated, UTIs can lead to more serious infections like sepsis and require hospitalization.

Wounds, Rashes and Bedsores: Wounds and infections can develop under diapers, pads or condom catheters because they allow the skin to be exposed to urine for extended periods of time. If the skin is compromised and left untreated, deeper wounds can result. Most men can use an external continence management device such as Men’s Liberty to eliminate dampness and reduce the possibility of wounds.

  1. Respected Drs.
    My name is Naresh Mody and I am from India and aged 61 years.

    I had Spinal Cord Injury due to tumor in spinal cord since 1996.

    I am Paraplegic and level is from D11 to L5.

    I am on ICP and frequently a victim of UTI.

    Recently, since a month there is a very heavy burning in my urethra and bladder.

    Sonography and routine urine analysis do not show any problem.

    Urologist suspected some swelling and started a treatment of Flavoxate and levofloxacin to be taken for 10 days.

    However, today there was slight leakage of urine.

    Please advise as to this problem. Is it leading to any other complications? What precautions do I have to take?

    With Regards,

  2. Well! Thank you for this informative website with the diagrams I have been looking for in regard to spinal injuries and loss of body functions. To put it mildly – I have been peeing my pants for the past 4 months ever since my destroyed lumbar and sacral spine made a “snapping” sound leading to excruiating pain. I have been in multiple accidents that have pretty much crushed my spine from top to bottom. So it sounds like my upcoming lumbar /sacral surgery will fix this – but this is not even the wnd of it.
    THE ABOSOLUTE WORST pain is in my thoracic spine and it seems like everyone just wants to ignore it. It appears to me they ignore it because I do not go crawling in the Doctor’s office unable to move and I am active and flexable. This is my hard work to keep moving but the pain gets worse and worse. It is completely debilitating. I have several compression fractures in this area, it also has been hyper-extended – basically pulling the whiole thing apart. Anyone have any advice on surgeries? We are talking stenosis and herniated discs. Any help would be greatly appreciated. I can’t keep gpoing like this – no sleep – every day in pain even with pain management.

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