Spinal cord injury is defined as damage to the spinal cord itself, often in combination with damage to the nerve roots in the lowest section of the spinal cord.
At least 7,500 Europeans suffer serious damage to their spinal cords which leaves them with permanent complications. One of these complications is a lack of bladder and bowel control. The most common cause of spinal cord injury is trauma and falls. Loss of bladder control after a spinal cord injury is often called “Neurogenic bladder dysfunction”. Neurogenic bladder dysfunction can also be caused by disorders such as Multiple Sclerosis, Parkinson’s Disease, a Stroke or Diabetes. The prevalence of neurogenic bladder has been reported in up to 81% of individuals with spinal cord injury, and this is a common contributor to poor quality of life. Surprisingly, incontinence, renal impairment, urinary tract infection and stones can all be caused by a spinal cord injury.
How Does the Spine Affect Bladder and Bowel Function?
The brain and the spinal cord play a key role in controlling bodily functions. The spinal cord is part of the central nervous system. Alongside the brain, it controls bodily functions including movement and behaviour. The upper urinary tract, consisting of the kidneys and ureters, is not directly affected by spinal cord injury. The lower urinary tract, however, has muscles that are affected by the spinal cord injury. The nerves controlling the internal organ are attached to the base of the spinal cord and pass down through the cauda equina, also known as the “horse’s tail”. If your spinal cord is damaged, the ability for signals to travel back and forth is impaired. Interestingly, different parts of the spine are responsible for different actions. The highest point of the spinal cord is known as the cervical spinal cord. This cord controls hand and arm function. The thoracic spinal cord on the other hand, controls the sensation and of the muscles of the chest, back and abdomen. A very important part of voiding involves the sacral spinal cord. Bladder function and bladder and bowel external sphincters are domains of the sacral spinal cord. When the bladder becomes completely full, it sends signals directly to the sacral spinal cord. When this communication is disrupted through an injury such as a fall, the message is delayed or often not even received. Complete spinal cord damage results in the spinal cord being completely cut off. No signals can travel, which means all feeling is gone below the point of injury. This causes urinary incontinence. In general, the higher your injury, the greater the loss of bladder and bowel function you experience. The main process affected by spinal cord injury is the emptying of the bladder. The detrusor and sphincter often become overactive due to the lack of brain control.
If you have had a spinal cord injury, look out for the following symptoms:
-Loss of bladder control
-Frequent urinary tract infections
-Feeling like you can’t fully empty the bladder
Managing Incontinence after a Spinal Cord Injury
Rehabilitation and assistive devices allow those with severe spinal cord injuries to remain productive. It is important to go to a Doctor and discuss the most appropriate treatment method for you. You can read about how others treat incontinence on our forum. Bladder management involves choosing a the best drainage method that is appropriate for you. For bowel incontinence, treatment strategies often feature schedule, nutrition, stimulation and surgical approaches. Following a voiding schedule can be useful, which trains the bowel when it should have a movement, preventing leakages at inappropriate times. You can read our blog section on faecal incontinence for more advice on managing faecal incontinence. It is important for extensive research to help clinicians recommend the most effective treatment for those who have spinal injury.
Barry West, aged 34, explains his struggle to come to terms with his incontinence due to a spinal injury. He asserts, “it just takes time to find a new direction in your life. I have been diving twice and don’t accept a boring life. With time and patience, you can enjoy day to day life with a spinal injury”.