Every spinal cord injury is different and may have different effects on how your bladder works. Even though your level of injury may be the same level as someone else’s, the plan for looking after your bladder might not be the same. The way you look after your bladder may also change over time.
After your injury you will have a neurogenic bladder.
This is a bladder that doesn’t work properly because of damage to the nervous system.
This damage may be in the brain, the spinal cord, or the nerves that connect from the spinal cord to the bladder.
Damage to the brain means that the messages that would normally go to the bladder aren’t happening and the bladder can’t be controlled properly.
Damage to the spinal cord or nerves connected to the bladder mean that the brain might try to send messages to the bladder but the damage to the spinal cord or the nerves means they can’t transmit the messages properly.
Reflexes in your bladder
A reflex is something that happens in your body without you needing to think about it. Your bladder mostly works using reflexes, however there is one part of your bladder that you normally have control over. This is the external sphincter.
There are sensors in the bladder muscle that detect when it is being stretched as the bladder fills. When enough stretching has occurred, the bladder muscle starts to contract and a message is sent from your central nervous system to coordinate the bladder muscle and sphincters so the bladder is ready to empty. When this happens people normally get the sensation that they need to pass urine and they can usually get to an appropriate place. Once ready, you then relax the external sphincter, allowing the urine out.
After a spinal cord injury, this reflex may still work but you may not be able to feel like you need to pass urine. You might not be able to control when you pass urine either. Depending on what effects your injury has had on your bladder, a plan will need to be worked out for your bladder management.
Soon after an SCI the body goes into a state called spinal shock. Spinal shock causes all reflexes to stop working. The bladder relies on reflexes to function normally so when a person is in a state of spinal shock, the lack of reflex activity means that the bladder muscles don’t contract and the sphincters don’t work properly.
Spinal shock usually lasts for about 6 weeks after the injury but can persist for a long time in some people. During this time bladder management for all people with SCI is the same; you will be fitted with an indwelling catheter. Once spinal shock has passed you can begin your own bladder management plan.