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What happens to the bladder, bowel, and sexual function?


The spinal cord also carries “autonomic” signals that control blood pressure, blood flow, breathing, sweating, bowel, bladder, sexual, and other autonomic functions.

• Bladder Paralysis and Spasticity. Spinal cord injury paralyzes the bladder. The bladder must be catheterized to drain urine. Indwelling catheters (such as a foley catheter inserted through the urethra) have a high risk of infections. Sterile intermittent catheterization is recommended but may be complicated by bladder spasticity or spontaneous contractions of the bladder. Bladder contractions can push urine into the kidney and this may lead to kidney damage. A drug called Ditropan suppresses bladder spasticity but have side effects such as dry mouth and eyes. Alternative approaches are available, including cutting the bladder sphincter so that urine drains freely into a condom catheter but this approach is not suitable for women. An approach that does not involve compromise of the urinary sphincter is placement of a suprapubic catheter or creation of a intestinal conduit from the abdominal wall to the bladder, i.e. a Mitrafanoff procedure.

• Bowel constipation and incontinence. The bowels usually operate without much voluntary control. However, spinal cord injury slows bowel activity and transit time of food in the gut. People use a variety of stimulants and suppositories to facilitate bowel activity. Bowel incontinence is a serious problem, often restricting social activity and employment options. A common technique is to establish a bowel routine to empty the gut on a set schedule. Artificial sphincters are available but the success rates of such procedures are still limited. Finally, alterations in secretion patterns can lead to indigestion, appetite changes, nausea, gallbladder stones, and other problems, especially in people with cervical spinal cord injury.

• Erection and ejaculation. Most people assume that spinal cord injury eliminates the possibility of sexual function. However, this is not true for a majority of people with spinal cord injury. Penile erection is a reflex and many men are able to have erections after spinal cord injury unless the injury involves the lower spinal cord or roots that control erection. Recent studies suggest that Viagra works for people with spinal cord injury. Vibrators or electrical stimulation can be used to facilitate ejaculation. Due to sphincter spasticity or poor coordination of the bladder sphincters, the ejaculate often goes into the bladder rather than outward. However, with a combination of electroejaculation and semen collection, it is possible to collect ejaculates from nearly all males. While spinal cord injury may interfere with menstrual cycles, a vast majority of young women with spinal cord injury remain fertile and can conceive.

  1. I am a T-6, complete para. I have been apralyzed for 8 years. I also have an indwelling folley, because my cauda aquina (sp?) nerve roots were damaged by an infection. I have not had sex since my injury. As a result I have not viewed any sexually explicit material either.

    Last weekend, I found a website that had really high quality, free (really!!) “adult films”. So, I watched one and then another. I sleep alone as my wife has issues with all of this (which are not relevant to my question/story). In any event, all of those old feelings came flooding back. I felt my penis, not much or any sensation. But touching my scrotum felt good to my hand and in my mind. In doing that, I brushed my chest and my nipples, which have always been very sensitive.

    That produced an incredible sensation. I kept touching them, while watching the movie and after several minutes, my stomach muscles contracted, which I can do a bit, and it felt like I had an orgasim. Nothing came out, but I had an incredible sense of relief. So, the next evening, I did it agiain. Same result. Now, however, my stomach aches (a lot) and my groin does too. After all this time I am afraid that I hurt something. Now the urge is back, but so is a lot of fear. I love in a rural area, a long way from a medical center where I could se a good “sex” therapist or even a urologist who knows abput parpplegics and sex. I am going to try to see a urologist about having an artificial sphincter muscle put in to control urination (I have no spasicity (sp?, again, sorry). If I could use viagra to get an erection and then feel those same feelings/sensations that might be something I strongly try to have done, rather than an illeostomy.

    So, have I done anything that might have hurt my bladder or testicles? Is it possible that I did have an orgasim (I guess I don’t care to much as long as I am not hurting myself, it felt good). Would a procedure in which a fluid pump is installed allow me to achieve an erection? I guess I will ask the urologist that, but I thought I get my three questions in now :o). Thanks for the comments and/or replies.

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