How are bladder changes managed?

Authors: SCIRE Community Team | Reviewer: Bonnie Nybo | Published: 18 January 2018 | Updated: 16 October 2024

In the early hospital phase right after injury, the circulatory system is stabilizing, and the prevention of infections and other complications is the priority. During this phase, an indwelling catheter is placed in the bladder to constantly drain urine from the bladder. The catheter will be changed regularly and maintained in a sterile way by your nurse.

After the acute phase, bladder care will involve transitioning to more long-term bladder care techniques and developing a suitable bladder routine.

A bladder routine is a regular routine of bladder techniques and treatments that are done every day to maintain bladder function and health. This usually involves techniques to regularly empty the bladder, prevent leaks, and avoid serious complications long-term.

Every person’s routine is different and often involves trial and error to find the methods that best meet your unique symptoms, abilities, preferences, and lifestyle. There is a wide range of different techniques and treatments that may make up your routine, including catheters, medications, and methods of stimulation like electrical stimulation. Keep in mind that spastic bladder and flaccid bladder happen for different reasons and are managed differently.

Other things to consider when developing a bladder routine:

• Timing and amount of fluids
• Caffeine and alcohol consumption
• Scheduling of bladder emptying (such as how long between catheterizations, before going to bed or certain activities, after drinking fluids)
• What type of equipment to use, such as type of catheter and collection bag for different situations
• What to do if you have a bladder infection or other new health problem
• Regular assessment of bladder care with your health team

The goals of spastic bladder management are to reduce overactivity in the bladder wall muscle which causes accidents, leaking, and wetness; as well as preventing high pressures within the bladder. This may include treatments such as:

• Indwelling catheters, condom catheters, and/or intermittent catheterization to drain the bladder
• Reflex voiding may help to empty the bladder for some people
• Anticholinergic medications may help to relax the bladder muscles
• Botulinum toxin (Botox) injections to help relax the bladder muscles
• Bladder augmentation surgery to increase the capacity of the bladder to hold urine

The goals of flaccid bladder management are to regularly empty the bladder to prevent overfilling and increased pressure in the bladder; and to prevent leaking and wetness. This may include treatments such as:

• Intermittent catheterization or indwelling catheters
• Condom catheters or pouches may be used to catch leaks but not for emptying
• Alpha-adrenergic blockers may help to relax the bladder sphincter muscles
• Botulinum toxin (Botox) injections
• Surgical techniques such as sphincterotomy or stents