How Spinal Cord Injuries affect the bladder and bowel

Bladder and bowel issues are a common consequence of spinal cord injury. However, with the right routine and the right products, you can take control and improve your quality of life. Consequences of Spinal Cord Injury

Consequences of Spinal Cord Injury

About 80% of people with a Spinal Cord Injury (SCI) will experience some or even a total loss of bladder control. The predominant symptom of this is an inability to pass urine, although urine leakage is also very common. In addition, 34% of people with SCI have bowel issues to a degree that affects their daily life.

It’s important to deal with these issues effectively so that you avoid troublesome complications and to ensure they have the least possible impact on your day-to-day life. Here are some solutions for the problems you might experience:

Inability to empty the bladder

Clean intermittent catheterization is an effective bladder management technique based on the regular and complete emptying of the bladder by using a catheter.


Leaking urine

Male External Catheters are an effective way to collect leaking urine for boys and men. The condom-like sheath is worn over the penis and is connected to a urine bag fastened to the leg.


Chronic constipation/bowel leakage

Re-establishing regular bowel habits can often be achieved by following an effective bowel management program using an anal irrigation system for constipation.


Spinal Cord Injury - the basics

Spinal cord injuries (SCI) usually result in loss of sensation and movement or permanent disability below the site of injury. They can be split into four groups, depending on the level of injury:

  • Complete tetraplegic (quadriplegic): Total loss of movement and sensation in all four limbs (i.e., arms and legs)
  • Incomplete tetraplegic (quadriplegic):  All four limbs are affected, however some sensation and limited voluntary muscle control remains
  • Complete paraplegic: Loss of movement and sensation in the lower part of the body
  • Incomplete paraplegic: Only the lower part of the body is affected, however some sensation and limited voluntary muscle control remains

Good to know

How can I deal with my bowel issues?

How can I deal with my bowel issues?

Issues such as bowel leakage and constipation are a common symptoms of conditions that cause damage to the central nervous system.

How to deal with bowel issues

How can I deal with my bowel issues?

Nerves in the spinal cord control bowel movement and if they are damaged, the feeling of needing to empty the bowel and the movement of stools through the body are affected. As a result, it can be difficult to tell when your bowel is full, and you can also have trouble controlling the release of stools. This can lead to different types of bowel problems: 

  • Bowel leakage
  • Constipation
  • A combination of the two


Bowel leakage

Bowel leakage occurs when you are unable to control your bowel muscles. This can result in accidental leakage of stools or having to rush to the toilet. Bowel accidents can be a distressing experience and can also lead to skin irritations and bladder infections, all of which can greatly affect a person’s confidence and general well-being.


Constipation occurs when stools in the bowel stay there for too long and become hard and dry. This makes it difficult to pass stools and results in the inability to have a bowel movement. Symptoms vary from person to person but the most common are straining, bloating and severe discomfort.

You may experience a combination of both bowel leakage and constipation – when softer stool or fluid leaks past hard stools stuck in the colon – often culminating in a bowel accident.

Whatever issues you are dealing with, it’s important to find a bowel routine that enables you to continue with your daily life in confidence.

Transanal irrigation and Peristeen®

Transanal irrigation and Peristeen®

Peristeen is an innovative transanal irrigation system from Coloplast for people who suffer from fecal incontinence or chronic constipation related to neurogenic bowel dysfunction. Using Peristeen minimizes the likelihood of involuntary bowel leakage.

Watch video about transanal irrigation

Transanal irrigation and Peristeen®

Peristeen is a unique way of emptying the bowel and is used to prevent faecal incontinence and chronic constipation.
The system has been specially designed to make it portable and easy to use. This offers independence and a sense of confidence to the user. In clinical trials with patients with spinal cord injuries, the Peristeen system reduced fecal incontinence and constipation and improved quality of life(2).

How does it work?

Peristeen is a technique for emptying the bowel by introducing lukewarm tap water(36–38°C) into the rectum using a catheter. The user sits on the toilet while the water is pumped into the rectum. The water is then emptied from the bowel, along with the stool, into the toilet. The results are normally so effective that most users only have to perform the procedure every other day.

How do patients begin using Peristeen?

Individuals must be assessed by a qualified health care professional to ensure this method is appropriate for them. They can then be taught the procedure to ensure the best result. Once people are comfortable with the system, it can give them the confidence to do more with their everyday life.


Download leaflet for ordering information and product codes (pdf).


How can I deal with my bladder problems?

Depending on your condition, you might need to use an intermittent catheter or a male external catheter. Either way, finding a product that meets your needs and fits your lifestyle is important for your overall quality of life. How to deal with bladder issues

Dealing with bladder problems

Dealing with bladder retention

If you have difficulty emptying your bladder, you will typically use an intermittent catheter. Your first step will be to find one that fits you and your lifestyle. Once you’ve decided on a catheter, it’s important that you follow the guidance in terms of how often you catheterize.

If you experience frequent urinary tract infections (UTIs), it could be a good idea to do the following:

  • Drink more fluid during the day
  • Increase how often you catheterize daily. Typically you will be advised to catheterize 4-6 times a day if you are not able to void by yourself.
  • Ensure you have clean hands and materials when catheterizing

If you keep getting UTIs despite following these guidelines, be sure to contact a healthcare professional.

Dealing with urinary incontinence

Male External Catheters are used effectively by many men dealing with urinary incontinence. These are discreet, condom-like sheaths worn over the penis and connected to a collecting bag worn on the leg.

It’s important you use the right size male external catheter while finding the right collecting bag depends on how much you leak.


Helping children empty their bladder

Because all children are different, it’s important to choose the catheter that’s right for their individual needs. Once they’re ready, you can help them learn how to empty their bladder on their own. Help your child to empty their bladder

Using a catheter to empty your child’s bladder

You will need to help your child urinate until they are about five years old. Most children with spina bifida cannot empty their bladder naturally, so you will need to use a catheter, which is a thin plastic tube that is inserted through the urethra and into the bladder. It’s a simple and painless technique.


Why bladder emptying is so important

It’s important that you and your child both understand why bladder emptying is so important and that you get into a good routine.

The goals of good bladder management are to:

  • Prevent damage to the kidneys and prevent infections in general
  • Get continent
  • Improve the child’s quality of life
  • Help the child become independent


If your child’s bladder is not emptied regularly, it can cause infections. Even small amounts of urine left in the bladder can cause infections.


Getting started

Before starting bladder emptying you should always consult a doctor or a nurse to get proper instructions in how to use a catheter.

Together with the healthcare professional, you will decide what type of catheter suits you and your child best and you’ll make a plan for how often to catheterise. Typically the bladder needs to be emptied 4–6 times a day – but this may depend on fluid intake and physical activities.

As a supplement you can use the animated user guides on this page to give you and your child a practical overview on how to catheterise. Choose the one that suits your child’s profile the best:


Coloplast also offers a step-by-step instruction you can print and bring to the toilet (pdf, 1MB).



Helping your child learn

When your child starts to show an interest – normally between the ages of three and five – you should start teaching them to empty their own bladder. Coloplast developed Wee Games to help you and your child learn how to do this in a fun way.


Urinary tract infections

When using catheters it is normal to experience urinary tract infections. Some people get them more often than others, but by following a few simple routines you can reduce the risk. Avoiding and preventing urinary tract infections

A urinary tract infection is an infection in the urinary tract, the series of organs that make up the urinary system. The presence of bacteria in the urinary tract is quite common and not necessarily a problem. If, however, the bacteria grow and multiply to a certain level, it may cause an infection of the urinary tract that needs treatment.

Symptoms of urinary tract infections

Symptoms of a urinary tract infection vary and may be subtle. They include:

  • Dark-colored and strong-smelling urine
  • Cloudy urine
  • Blood in the urine
  • Fever/sweating
  • Bladder spasms
  • Increased muscle contractions in your leg

If you experience any of the symptoms listed, you should consult your nurse or doctor.

Avoiding urinary tract infections

While there is no definite solution to avoiding urinary tract infections, there are a number

of simple precautions that can help you prevent and sidestep recurrent infections: 

  • Generous intake of fluids – at least 1.5 litres a day
  • Good personal hygiene – especially when you catheterize
  • Catheterization routines – complete emptying the bladder regularly
  • Healthy digestion – a good bowel routine may reduce the risk of urinary tract infections

Changing the type of catheter you use may help reduce the number of urinary tract infections you experience.


Frequently asked questions

Here you will find answers to the most common questions relating to spinal cord injuries and bladder and bowels. FAQs

FAQs on SCI and bladder

Why does an SCI cause bladder issues?

The bladder, which stores urine, is controlled by the nervous system. When you experience a spinal cord injury, it is likely the nerves controlling your bladder are damaged. As a result, bladder function is affected. Some people find that they need to urinate more frequently or urgently; some experience urine leakage, and others experience difficulty emptying the bladder.


How can bladder issues affect my lifestyle?

If your bladder is not emptied regularly, it can cause infections. These start in the bladder but can move back to the kidneys and cause serious renal damage. Even small amounts of urine left in the bladder can cause infections.

Alternatively, if you cannot control the urge to urinate, you may experience leakage. This may lead to embarrassing odors. Consequently, it is important to care for your bladder in a way that has the least impact on your daily life.

 What can I do to deal with my bladder issues?

There are a number of methods and products available to help manage your bladder issues. These include catheters, Male External Catheters (for men) and absorbent products. Search for the right product or contact Consumer Care for assistance.


Order Free Catheter Samples

 What is a catheter?

A catheter can be used to ensure the bladder is completely emptied. It’s a slim, flexible tube that is inserted into the bladder through the urethra and which enables the urine to drain.

 Why is it important to empty my bladder?

Not emptying your bladder regularly can lead to infections. These start in the bladder but can move back to the kidneys and cause serious renal damage. Even small amounts of urine left in the bladder can cause infections.

 Can I just empty my bladder in the morning and in the evening?

No. You should follow the schedule your doctor has given you. Generally, the bladder should be emptied at least 4–6 times a day.

 Can I drink less so that I don’t have to empty my bladder so often?

No. It is very important that you drink enough. This keeps the urinary system clean and healthy.


What if the urine looks cloudy or dark and smells funny?

You may have an infection. Talk to your doctor or nurse.

 Does it hurt to catheterize?

No. You might feel some pressure when the catheter goes in. If you experience discomfort or if it is difficult to slide in the catheter, take a short break. Try to relax by taking a deep breath or by coughing. Talk to your doctor or nurse if you find it painful.

 What if I get frequent urinary tract infections?

Using an intermittent catheter does increase the risk of urinary tract infections. However, compared to other catheter types such as permanent (indwelling) catheters, intermittent catheters are less likely to cause urinary tract infections. There are ways to reduce the risk of urinary tract infections:

  • Drink more fluid during the day – the principle here is simply to wash out the urinary tract, providing you continue to catheterize
  • Make sure that the bladder is fully emptied every time you catheterize
  • Increase the number of daily catheterizations
  • Make sure you have clean hands and equipment when doing the catheterization
  • Reassess your intermittent catheterization technique


What should I do if I’m still leaking urine?

Urine leakage may occur for different reasons: 

  • A urinary tract infection may cause urine leakage, and you should contact your doctor if you suspect you have one. The typical symptoms to be aware of are:
    • Dark colored and strong-smelling urine
    • Cloudy urine
    • Blood in the urine
    • Fever/sweating
    • Bladder spasms
    • Increased muscle contractions in your leg 
  • Leakage may also occur because you don’t catheterize often enough (less than four times a day). You should:
    • Consider catheterizing more frequently to avoid the bladder pressure from building
    • Make sure your bladder is fully emptied every time you catheterize
    • Reassess you intermittent catheterization technique
    • If you are catheterizing more than seven times per day and are still having problems with urine leakage, you may wish to consult your doctor
  • You may leak because you have involuntary bladder spasms/contractions (not caused by a UTI). You should:
    • Talk to your doctor about the possibility of medication to relax your bladder 

If the leakage mainly occurs doing physical exercise, you should consider catheterizing before you start to exercise. 


Finding the right product

Coloplast offers a wide range of products to help you with bladder and bowel issues. Here are a few suggestions for what to look for when choosing a product. Read more

Finding the right product

Taking care of your bladder

Products that can help you with your bladder issues include:

  • Catheters – for urinary retention (when you can’t empty your bladder naturally)
  • Male External Catheters and urine bags – for men who can’t control when they pass urine  

What to look for when choosing a catheter

Finding the right catheter is very important in order to make sure that the bladder is emptied safely and with as little hassle as possible. Use the links below to read more about the key factors to consider when choosing a catheter

  • Ease of use 
  • How it fits you and your lifestyle 

Lastly, when discussing product choice with your healthcare professional, make sure you also talk about your lifestyle, concerns and special needs.

Coloplast’s catheters

Coloplast offers a range of catheters. Here are brief descriptions of the most popular ones: 


  • Instantly ready to use – straight from the packaging
  • Intuitive handling – with no preparation required
  • Minimized risk of urethral damage due to the smooth coating of the catheter and eyelets


SpeediCath® Compact – all the benefits of the regular SpeediCath and more

  • Discreet – the most compact catheter for women and men
  • Compact- small enough to fit in your pocket or a handbag
  • More hygienic catheterization – with the easy-grip handle*

*Only for SpeediCath Compact female

Taking care of your bowels 


There are ways to take care of your bowel issues. One method is bowel irrigation to prevent bowel leakage and constipation.


Bowel irrigation is a well-documented technique for emptying the bowel. Water is introduced in the bowel via the rectum. The water is then emptied from the bowel along with the stools. It enables you to empty your bowels on a regular basis, helping to prevent bowel leakage and constipation.

Products from Coloplast

Peristeen®, Coloplast’s bowel irrigation system, offers predictable bowel management. As it only requires water, Peristeen is an effective alternative to other bowel management methods that also require medication. Peristeen:

  • Prevents bowel leakage and constipation for up to 2 days
  • Enables you to decide when to empty your bowels
  • Improves quality of life

Tips, tools and guides

Bowel emptying guides

Below you can find video guides for children and adults on how to use Peristeen® for anal irrigation.

Getting started using Peristeen®

Getting started using Peristeen®

Using Peristeen® to manage your bowels can be challenging at first, but with the right training and routine, you’ll soon start to see the benefits.

Watch step-by-step Peristeen® guide for adults

Getting started using Peristeen®



Using Peristeen® daily or every other day, as recommended by your doctor or nurse, helps prevent bowel leakage and constipation. This means that you don’t have to worry about leakage and can feel confident to do things you want to do.


Take your time

Using Peristeen® will mean having to get used to a new routine, but the effort will pay off. Regular emptying of your bowels can make a big difference to your quality of life.

The three most important things to remember when getting started: 

  • Use Peristeen® regularly. Keep to the plan that your doctor or nurse has recommended. Regular bowel emptying with Peristeen® helps prevent leakage and constipation. It can also reduce the time you need to spend taking care of your bowels. 
  • Find a time when you can empty your bowels without being disturbed or rushed. The exact time that you empty your bowel is not critical, but try to keep to the same each day, so that you get in a regular routine. 
  • Keep in regular contact with your doctor or nurse during the first few months of using Peristeen®. They can help you with any queries you might have and help you adjust your routine if needed. You can also contact Coloplast Consumer Care for advice and support.
Helping children manage their bowels with Peristeen®

Helping children manage their bowels with Peristeen®

Learning how to empty their bowels is an important step in every child’s development. Using Peristeen® can help them feel more confident and give them the freedom to take part in social activities.

Watch the step-by-step guide for children using Peristeen®

Helping children manage their bowels with Peristeen®


Most children with spina bifida, especially when they are younger, rely on their parents to help them empty their bowels. Traditional methods to prevent bowel leakage and constipation include change of diet, suppositories, enemas, constipates, stool softeners and laxatives.

More predictable

Some children, however, find these methods of treating the bowels ineffective, as you cannot schedule when you will have a bowel movement, which often results in bowel accidents.

Bowel irrigation is one type of bowel care routine that ensures bowel movements are both regular and predictable. If performed regularly, it will make your child feel more comfortable and prevent problems such as bowel leakage and constipation.

What exactly is bowel irrigation?

Bowel irrigation is when water is introduced into the bowel via the rectum, using a rectal catheter. The water stimulates the bowel and flushes out the stool. The process takes about 30–45 minutes. After irrigating, the lower part of the bowel is empty. Bowel irrigation is performed every 1 to 2 days.


It is important to do it regularly as:

  • Regular irrigation prevents bowel accidents, simply because the lower bowel is empty of stool
  • Regular irrigation prevents chronic constipation as it encourages bowel movements, meaning they become regular 


Until your child learns how to irrigate himself or herself, you need to make sure that it is done correctly and safely. Find a good, regular routine that works and encourage your child to take an interest. They will have to do it themselves when they are older.

It can be a good idea to keep track of your child’s progress. For inspiration, why not download and print a the Bowel Emptying Diary (pdf, 1MB).

Coloplast offers a bowel irrigation system called Peristeen®.


Self-catheterization guides

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