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Spinal Cord Injury (SCI) & Bladder Problems

Spinal cord injury is an unfortunate reality for many Americans. Bladder problems, such as loss of bladder control, develop as a side effect of spinal cord injury. Catheters from FreedoMed can provide people living with spinal cord injuries more independence as they will be able to interact with others without fear of embarrassment. If you have a spinal cord injury, catheters could be a good way to help you manage your bladder problems.

About Spinal Cord Injury

The spinal cord is a large bundle of nerves that runs from the base of the brain down to the waist. It carries nerve impulses from the brain to the nerves that control the rest of the body (muscles, organs and tissues). This is why a spinal cord injury can cause bladder problems. The spinal cord is protected by bones called vertebrae that make up the spinal column.

There are 30 vertebrae named according to their location within the spinal column:

  • Cervical (Neck) – 8 vertebrae (C1-C8)
  • Thoracic (Chest) – 12 vertebrae (T1-T12)
  • Lumbar (Low Back) – 5 vertebrae (L1-L5)
  • Sacral (Hips) – 5 vertebrae (S1-S5)

When the spinal cord is damaged, messages can no longer travel to and from the brain and the nerves affected by the injury. That's why spinal cord injuries result in the loss of function, feeling or mobility at and below the level of injury (resulting in associated bladder problems):

  • Injury at the cervical level causes loss of function/feeling in the arms and legs, resulting in quadriplegia.
  • Injury at the thoracic level causes loss of function/feeling in the chest and legs, resulting in paraplegia.
  • Injury at the lumbar and sacral levels cause loss of function/feeling in the legs and/or hips, resulting in paraplegia.

In general, the higher the level of injury, the more body parts and organs are affected. For example, a person who sustains an injury to C1-C4 may require a ventilator to breathe.

The loss of function or feeling can be categorized as complete or incomplete. In a complete injury, there is no function or feeling below the level of the injury, and it affects both sides of the body equally. However, an incomplete injury means the person has some level of function or feeling below the level of the injury such as:

  • The ability to move one limb more than another
  • The ability to feel parts of the body that cannot be moved
  • The ability to move or feel one side of the body more than the other

Thanks to advances in the treatment of SCI, incomplete injuries are becoming more common, although many patients still deal with bladder control problems.

Other effects of SCI may include:

  • Bowel and bladder problems
  • Sexual dysfunction
  • Fertility problems (especially in men)
  • Spastic muscles
  • Muscle atrophy
  • Low blood pressure
  • Inability to regulate blood pressure effectively
  • Inability to regulate body temperature
  • Inability to sweat below the level of injury
  • Chronic pain
  • Depression and emotional changes

Facts about Spinal Cord Injury (SCI)

  • Approximately 231,000 to 311,000 people live with SCI in the U.S.
  • There are about 12,000 new cases of SCI every year in the U.S.
  • The majority of SCIs (81%) occur in males.
  • The average age at time of injury is 40.2 years old.
  • The majority of spinal cord injuries result from motor vehicle accidents (41%), falls (27%) or acts of violence (15%).
  • Quadriplegia is slightly more common than paraplegia (55% to 44%).
  • Some people develop bladder problems due to their SCI.

What Causes Bladder Problems with SCI?

Bladder problems occur as a result of damage to the spinal cord. The sacral nerves at the base of the spine control bladder function, so virtually any level of spinal cord injury results in bladder control problems.

The bladder holds urine, and the sphincter muscles at the neck of the urethra control the flow of urine from the bladder. Following SCI, messages from the bladder and sphincter muscles can no longer reach the brain, which means you cannot feel when the bladder is full. Bladder problems occur because you may not feel the urge to urinate or your bladder may not empty completely (urinary retention).

There are two types of bladder problems associated with SCI: spastic (reflex) bladder and flaccid (non-reflex) bladder. With a spastic or reflex bladder, a reflex triggers the bladder to empty when it becomes full. The problem is that you cannot feel or control this reflex, so you either leak urine or urinate involuntarily (urinary incontinence). Of the two types of bladder problems, this one typically occurs when the SCI is above the T12 level.

With a flaccid or non-reflex bladder, the reflex that triggers the bladder to empty is either non-existent or sluggish at best. When this happens, the bladder may become so distended that urine backs up into the kidneys, which can cause a kidney infection. Or the bladder may not empty completely and retain urine. Of the two types of bladder problems, this type usually occurs when the SCI is at or below the T12-L1 level.

Treatment for Bladder Problems

Individuals with SCI and associated bladder problems will need a urinary catheter to manage their bladder problems. Someone who has a spastic bladder may use a single-use, intermittent catheter or indwelling (Foley) catheter. Males may choose to use an external condom catheter instead. Those with a flaccid bladder typically self-cath with intermittent catheters.

Complications of bladder problems resulting from SCI include urinary tract infections, sepsis, dyssynergia, kidney stones or bladder stones and bladder cancer in those who use indwelling catheters for a long period of time.

To avoid complications from bladder control problems, empty your bladder on a regular basis, and make sure it empties completely. Keep your catheter and supplies clean, and always clean the area around the catheter with soap and water prior to catheterization. Wash your hands before and after self- catheterization. Keep the skin around the catheter clean and dry to prevent skin breakdown and infection. Keep hydrated and drink the amount of fluid recommended for the type of catheter you use. Try to drink mostly water and limit the amount of alcohol and caffeine you drink. Following these tips can help deal with bladder problems.

Let FreedoMed Help with Your Bladder Problems

If you've suffered a spinal cord injury and are now dealing with bladder problems, we can help. The ability to self-cath gives you back a degree of independence, allowing you to take care of your bladder problems on your own. If you are currently on Medicare, you may even be eligible to receive catheters to help with your bladder problems for free! Fill out an eligibility form to see if you quality today!

To learn more about SCI, visit or the National Spinal Cord Injury Association.

*Co-payments, deductibles and some restrictions apply.