Bladder & Bowel

Normal bladder function

If the bladder is empty, the bladder muscle (detrusor) relaxes and the sphincter contracts – the bladder is shut.

The nerves connected to the bladder wall register the bladder stretching, and as it fills, they carry a message to the brain. During urination, the sphincter muscle relaxes deliberately to allow the opening of the urethra.

What is the difference with a...

Passing urine with a condom catheter

The urine is drained into the bag using reflexes – this means rhythmical tapping (triggering) on the lower abdominal region above the pubic bone triggers the drainage of the bladder. This drainage technique only works in the case of spastic cystoparalysis.

How does triggering work?

Triggering enables a stimulation of the reflex arc1 – thus the emptying...

Urination through catheterisation

Catheterisation is mostly applied in people with spinal cord injury with a flaccid bladder. A local medical sedation can sometimes enable catheterisation in patients with a spastic bladder. In order to live as independently as possible, it is important to learn self-catheterisation – this is also feasible for tetraplegics with a low level of spinal cord...

What types of indwelling catheter are there, and what are the differences between them?

A suprapubic urinary catheter is an indwelling catheter that is inserted into the bladder through the abdominal wall. This allows the urine to permanently flow out of the bladder without having to pass the urethra.

There are different types of catheters and options to attach them. Often a small balloon is...

What is a bladder stimulator?

A bladder stimulator is an implant with which the nerves of the bladder and bowel can be stimulated directly, enabling the bladder and bowel to be emptied. It can only be used on people with a complete spinal cord injury and spastic cystoparalysis.

How does a bladder stimulator work?

Signals are sent externally to an implanted receiver (D) using a controller...

A urinary tract infection (UTI) is an infectious disease of the efferent urinary tracts caused by pathogens. People with spinal cord injuries are at increased risk of suffering from a urinary tract infection. Urinary tract infections are identifiable through specific symptoms (symptomatic). The infection can spread into the kidneys and blood stream, leading to threatening clinical pictures.


Normal bowel function

The emptying of the bowel (defecation) is a reflex-type process, but one which you can consciously influence. If the rectum1 is sufficiently full and therefore stretched, an impulse is sent through the nerves to the defecation centre in the spinal cord. This triggers the sensation “urge to defecate” in the cerebrum. The defecation centre controls the rectum muscles and...

Emptying the bowel should occur periodically (every one or two days) possibly around the same time. Doing so trains the bowel and therefore allows you to maintain or regain control over defecation.


You can help to regulate your bowel movements by paying careful attention to your habits and activities. Do you normally always empty your bowel in the morning? Or do you prefer to go to...

Medical stimulation and the regulation of stool consistency are often necessary in order to control defecation in people with spinal cord injury (SCI). Laxatives1 can be hazardous to health, although many of them are herbal. The principle is: as little as possible – as much as necessary.

Taking laxatives can induce a habituation effect – they are therefore not suitable for long-term use....

Flatulence is a common problem. Is it a problem for you too? People with spinal cord injuries are frequently affected due to a disorder in bowel functions.

Flatulence caused by nutrition

Flatulence can occur right after eating and be caused by the following foods, among others:

  • Cabbage
  • Herbs
  • Onions and other bulbous plants
  • High-fibre foods
  • High-sugar foods

Flatulence problems as...