Spinal cord injury and bladder problems

The spinal cord is part of the central nervous system. Together with the brain it controls bodily functions including movement and behaviour.

The spinal cord is protected by the bones of the spine and is cushioned by a clear fluid called cerebral spinal fluid. Nerves enter and exit the spinal cord at different points to control the various parts of the body. The spinal cord forms a vital link between the brain and the rest of the body – if damaged, sensation and movement may be impaired or completely lost.

The extent to which a spinal cord injury will lead to bladder and bowel problems depends largely on two factors: whether the injury is complete or incomplete and the level of the spinal cord injury (high/low). Spinal cord injuries can be split into four groups:

• Complete injury: no voluntary movement or sensation below the site of injury
• Incomplete injury: some sensation remaining below the site of injury
• Tetraplegia (quadriplegia): paralysis involving most of the internal organs and all four limbs 
• Paraplegia: complete or incomplete paralysis, affecting the legs and sometimes the internal organs, but not the arms

The impact of a spinal cord injury on the bladder can result in involuntary messages to contract the bladder being received by the bladder causing leakage, or wetting. When no messages to contract the bladder are received, then the bladder is not emptying and it retains urine. The urine must be emptied to maintain health and prevent damage to the kidneys, this is most often achieved using intermittent catheterisation.

Most people with a spinal cord injury will experience bladder dysfunction known as neurogenic bladder, which means they have a decreased ability to control their bladder. Learn more about how the bladder works.

• Small or large amounts of urine leaking without warning or without feeling the urge to go to the toilet
• Inability of the bladder to empty completely 
• Urinary tract infections (UTIs)