Reflex emptying is a method of bladder management that uses the reflex activity of your bladder muscle and sphincter.
How does reflex emptying work?
Under normal circumstances the reflex activity of your bladder muscle and sphincters coordinate. As the bladder fills the muscle stretches. This triggers a reflex response that causes the muscle to contract, increasing the pressure in the bladder. At this time, the sphincters would normally relax, but the SCI stops this from reliably happening.
With reflex emptying the sphincter relaxes intermittently, which allows urine to pass. Sometimes you have no control over your external sphincters after an SCI, and equipment is needed to collect and store the urine.
Considerations for reflex emptying
Reflex emptying is only recommended if:
- Bladder pressures are safe (this is determined during urodynamics)
- No or little urine is left in the bladder after you empty.
Reflex emptying is not for everyone
Reflex emptying can be damaging if the pressure inside the bladder is too high when urine is passed. This pressure might be so high that urine flows back into your kidneys. This is known as vesicoureteral reflux. This is usually caused by the external sphincter not opening.
It’s also important that your bladder empties properly. Think about stagnant water, and the algae that form. When excess urine is trapped or not allowed to flow it is the perfect breeding ground for bacteria, allowing it to multiply and cause infection.
It’s recommended that people who use reflex emptying as bladder management have yearly urodynamic studies.