Do you or someone you know have nerve damage to the bladder as a result of a spinal cord injury? Having a regular bladder routine decreases unpleasant incidents, infections, as well as the threat of autonomic hyperreflexia*.
A neurogenic bladder takes control of storing or emptying urine outside of the body. Some people with spinal cord injuries cannot store urine (reflex/spastic) which results in a loss of control over emptying and can sometimes result in accidents.
More commonly, neurogenic bladder patients cannot empty their bladder (flaccid) or pass urine without the use of a catheter. Your doctor will help you choose the most appropriate catheters for you.
Straight or Disposable Catheters
These catheters can be used if you can empty your bladder at specific times. Either you or your care giver can drain the urine by manually inserting the catheter through the urethra and into the bladder. Once the bladder is emptied the catheter can be removed.
A Foley catheter stays in position in the bladder by way of the urethra to enable the steady collection of urine into a bag that can be emptied by you or your caregiver as required. This method is more commonly used by individuals who are not able to self cath or who cannot withstand recurring catheterization on a daily basis.
With this type of catheter a surgeon creates a stoma in the abdomen where a catheter is inserted directly into the bladder bypassing the urethra entirely. The urine is stored in a drainage bag and emptied by you or the caregiver.
This option is for men. The catheter looks like a condom and slips over the penis and collects urine as it drains. Condom catheters are not a preferred method of collection due to the long term skin irritation of the penis. The condom catheter can cause bacteria to re enter the body and is not the most sterile method of drainage.
Botox injections (just one of the many medication options) can be used to relax the muscles supporting the bladder to minimize painful spasms.
When using this method it is very important to keep yourself clean and dry. Wet, soiled skin will break down quicker than clean, dry skin. Broken skin can result in bacterial infections which can lead to sepsis. Sepsis is an infection of the bloodstream. It is life threatening and should be considered a medical emergency.
Autonomic hyperreflexia occurs when the patient blood pressure spikes dangerously high. It is considered to be a medical emergency. It could be a consequence of a urinary tract infection, fecal impaction, or a bladder that is excessively full. This problem is more prevalent in patients who have a higher level of injury at T6 level or above.
Proper Hygiene and Preventing Infections
Proper hygiene and keeping catheters sterile is critical. Incorrect handling of catheters can introduce germs and bacteria into the bladder resulting in infections and illnesses.
Symptoms of an infection can include lower abdomen pain, reduced output of urine, burning, urine that has an uncommon shade or smell, and fever. Bladder infections can be very serious, resulting in kidney failure and sepsis if not dealt with immediately.
Affected individuals who use an indwelling catheter like a Foley or suprapubic are more susceptible to infections of the urinary tract. Bladder hygiene is an important part of staying healthy after a spinal cord injury. Contact your doctor immediately if you feel that you might have an infection.
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