What is a neurogenic bladder?

From the outside, probably the most obvious effect of a spinal cord injury is paralysis. However, damage to the spinal cord can cause other complications that affect the person’s independence and dignity.

As the Christopher & Dana Reeve Foundation discusses on its website, most spinal cord injuries affect bladder control, because the nerves that control the bladder are at the base of the spinal cord. When those nerves get cut off from the brain, the victim has what is called a neurogenic bladder.

Retaining and releasing urine uses a relatively complex system of muscles contracting and relaxing. After a spinal injury, the nervous system may lose the ability to control some or all of those muscles. This usually causes one of two problems: spastic bladder or flaccid bladder.

A spastic bladder will reflex unpredictably when full, causing it to empty automatically, without the victim being able to control it. Meanwhile, a flaccid bladder becomes stretched out because of sluggish or absent muscles. Once distended, the bladder may struggle to empty completely.

Medication can help, but the most common method for emptying the bladder is catheterization. Options include intermittent insertion of a catheter into the urethra, or using an external condom catheter and a collection bag. Surgery can create an alternate catheterization site or expand bladder capacity, which can reduce how often one must use the catheter.

Besides trouble controlling urine, possible complications of a neurogenic bladder include bladder infections, stones, kidney distention, kidney inflammation and renal failure.

Bladder problems after a spinal cord injury can be dealt with, but can also be debilitating. The cost of handling the effects of a neurogenic bladder could be one of the things victims of negligence can be compensated for.