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D - Bladder Continence

Bladder Continence | Body Structure and Function J Hsieh, MSc; K Ethans, MD; M Hassouna, MD; B Welk, MD; C Craven, MD; and the E-Scan Investigative Team The goals of neurogenic bladder management after spinal cord injury (SCI) are to achieve continence, with regular and timely bladder emptying to avoid urinary stasis, high filling and voiding pressures; to reduce urinary frequency and urgency, and to prevent and treat complications such as urinary tract infections (UTIs), stones, strictures and autonomic dysreflexia. The focus of this chapter is the management of neurogenic overactive bladder. cause kidney damage (see Figure 1.0). Infections may worsen incontinence, and/or cause increased pain, body spasms or fever. Most people with this type of bladder dysfunction have to catheterize (insert a tube in the bladder) every few hours, to empty the bladder, and to reduce bladder pressure and incontinence. Individuals with SCI are often prescribed medications to relieve a spastic overactive bladder, increase bladder capacity, and decrease loss of bladder control, between catheterizations. Kidney Bladder muscle Urine Internal sphincter muscle External sphincter muscle After SCI, individuals experience loss of control over bladder function. This results in a bladder that may be overactive, have a reduced ability to hold urine, and a urinary sphincter properly while The voiding. Urinary In addition, an individual System that does not relax with SCI often cannot feel when the bladder is full, so may have incontinence as it fills. An inability to empty the bladder effectively leads to urinary stasis, and can cause urinary tract infections. High bladder pressures can cause the urine to transmit pressure back up to the kidneys and FIGURE 1.0 The Urinary System Ureter Urethra Pelvic floor muscles BLADDER CONTINENCE | BODY STRUCTURE AND FNUCTION 53


D - Bladder Continence
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