Urinary System Nerve Changes after SCI

Voluntary control of urination requires spinal communication between the lower urinary tract and the brain. After a spinal cord injury (SCI), this communication is disrupted. The brain is no longer able to use the spinal cord to communicate with organs below the level of injury. Therefore, the normal signals to empty the bladder, or to inhibit the bladder from emptying, are not properly sent or received. Without input from the brain, the bladder becomes "neurogenic" or "neuropathic."

Reflexes often remain intact below the level of injury. Over time, some reflexes even become hyperactive when the inhibitory effects of the higher neuro function is lost.

Though there are many possible effects of SCI on the urinary system, they all involve some combination of changes in muscle activity or sensation. The muscles involved can be the detrusor muscle of the bladder, the striated muscle of the sphincter, and/or the smooth muscle of the internal sphincter or urethra. The changes in sensation can involve the bladder and/or the urethra.

We can classify spinal cord injuries according to location of the lesion. Then, we can make some generalizations about the SCI's effect on the urinary system.


Instant Feedback:

A bladder that is hyperreflexic is overactive. It tends to empty "automatically".

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False


Instant Feedback:
   Suprasacral lesions (lesions above the sacrum) often are associated with detrusor sphincter dyssynergia.
True
False

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