Bladder Dysfunction: A Side Effect of Spinal Cord Injury

Incontinence and other bladder dysfunctions are physical, emotional, social, and economic challenges that many spinal cord injury victims face every day. Victims may need to rely on costly medical equipment, special supplies, or take medication for the rest of their lives. These are factors to be considered when filing a personal injury claim.

What Is Bladder Dysfunction?

The location and severity of a spinal cord injury will determine what type of bladder dysfunction occurs. The higher up the injury is on the spinal cord, the more serious the consequences for the injured victim’s health.

Bladder dysfunction, also known as neurogenic bladder disorder, can cause:

  • Urinary incontinence, which is the loss of bladder control
  • Loss of ability to empty the bladder
  • Overactive bladder
  • Frequent, and often serious, urinary tract infections

The Connection Between Bladder Dysfunction and Spinal Cord Injuries

Approximately 10,000 Americans a year will experience a spinal cord injury. These injuries can happen in automobile accidents, slips and falls, athletic activities, or during surgery. The mention of a spinal cord injury usually sparks a mental image of paralysis, like paraplegia, the loss of leg function, or tetraplegia, the loss of all limb function. However, there is also a connection between spinal cord injuries and bladder dysfunction, even when paralysis has not occurred.

The spinal cord is a very delicate part of the body and is extremely susceptible to injury. It sits inside a fluid-filled canal that runs through the spine’s vertebral column. The spinal cord holds nerve cells that send signals to the brain, organs, and muscles throughout the entire body. These signals allow the movement of legs, arms, and muscles, including those that control the body’s ability to empty the bladder and bowels.

The severity of a spinal cord injury depends on how high up the nerve damage is or whether the cord has been completely severed. When the spinal cord is severed, all feeling and movement below the point of injury ceases. If the damage is incomplete, the individual may retain some movement or nerve function, but it can be impaired.

The Emotional Toll of Bladder Dysfunction

Spinal cord injury victims often face an extensive recovery period that does not always result in a full recovery. Only about 30% of people experiencing bladder dysfunction from a spinal injury will fully recover.

Patients with bladder dysfunction often require the manual release of urine using catheters. Some need surgery to repair spine damage. Many patients must use personal products, like adult diapers to escape the embarrassment of incontinence. This all takes an emotional toll on these victims.

Types of Bladder Dysfunction Associated with Spinal Cord Injuries

There are multiple types of bladder dysfunction associated with spinal cord injuries. They range in severity and may be only temporary or permanent injuries.

One type of temporary bladder dysfunction is caused by spinal shock from a supra-sacral spinal cord injury. The shock may last between two to six months and could cause overactive bladder symptoms to occur or prevent the natural release of urine.

When a spinal cord injury occurs above vertebra TH12/L1, the brain often loses control and steering of urination and detrusor-sphincter dyssynergia occurs. With no steering available for the nerves that control the bladder, reflexes take over and trigger impulses to the bladder and its sphincter. This causes them to work against each other and allows a dangerous level of pressure to build up that causes urine to back up into the kidneys. The condition could destroy the kidneys and increase the risk of infection and incontinence.

With a spinal cord injury at or below vertebra TH12/L1, the individuals will often lose muscle tone in their bladder and its sphincter. This can result in urine retention, incomplete emptying, incontinence from urine overflow, and urinary tract infections. The nerves in the lower spinal region are responsible for reflex bladder emptying. If the spinal cord is severed in this lower area, the bladder muscle will be unable to contract to empty the bladder. If the injury only affects some nerve fibers, partial function may remain but only some muscles may be activated.

Injuries, such as herniated discs or spinal fractures can cause bladder nerves in the spinal cord to become inflamed, irritated, or compressed. Bruising or constriction of blood flow can interfere with the transmission of signals from the nerves. The injured may experience frequent urination, a sudden overwhelming urge to urinate, or incontinence.

Cauda Equina Syndrome (CES) is a serious medical condition that occurs when the cauda equina sac of nerves located at the base of the spinal cord is squeezed or compressed. This condition requires immediate medical attention and results in severe lower back pain and urinary incontinence. Depending on the damage to the nerve tissue, surgery may be needed to decompress the spine.