There are several different discrete bladder management systems
that are commonly used after a spinal cord injury. They
are listed below with a short description of each afterwards:-
A tube is inserted through the abdomen and into
the bladder, where a balloon on the end holds it in place. It
remains in the bladder and drains constantly, so the bladder is
The bladder is drained by having a tube inserted
which then drains urine into a bag. Most commonly seen in
early hospital stage of rehabilitation and not normally used
again unless infection is a problem. Tube can be clamped
to allow bladder muscle to expand.
You drain your bladder several times a day by inserting a
small rubber or plastic tube. The tube does not stay in the
bladder between catheterisations. Several different
discrete types of intermittent catheter are available and this
is one of the common preferred methods of bladder management
post hospital stay.
External Bladder Control Methods:
- Condom / Conveen Drainage
A condom catheter is a way to drain the bladder
without putting a catheter (rubber tube) inside your urethra.
The urethra is the tube that runs from the outside of your
body into your bladder. The bladder is where urine is stored
in your body. A condom catheter is a rubber sheath that is put
over your penis. It is also called a texas catheter. The
catheter allows your bladder to empty without using a urinal,
bedpan, or toilet. The condom catheter is hooked to a plastic
tube which leads to a bag. The urine stays in the bag until it
is emptied into the toilet.
- External Continence Device (ECD)
An ECD is a method of continence management that attaches
only to the tip of the penis using hydrocolloid, a
hypoallergenic adhesive commonly used in wound and ostomy
care. Urine is directed into a collection bag and does not
come in contact with skin.
The bladder muscles contract to start the bladder-emptying
process. This may be under your control (voluntary) or not
- Normal Voiding
This is done under your control. When the bladder gets
full, messages are sent to the sacral level of the spinal cord
and carried to the brain. The brain sends messages back to the
bladder to contract, and to the sphincter muscle to open, so
you can void.
This surgical process weakens the bladder neck and
sphincter muscle to allow urine to flow out more easily. After
this surgery, you will urinate involuntarily, and must wear a
- Condom/Conveen Drainage
These collection devices are worn by men for
incontinence problems or after sphincterotomy (see above).
They are made of latex rubber or silicone that covers the
penis and attaches to a tube that drains into a collection
Voiding is encouraged in one of several ways, such as:
- Anal or Rectal Stretch
This method for relaxing the urinary sphincter is usually
used along with an abdominal corset and valsalva (see below).
This method involves manually pressing down on the
The area over the bladder is tapped with the fingertips or
the side of the hand, lightly and repeatedly, to stimulate
detrusor muscle contractions and voiding.
This method involves increasing pressure inside the
abdomen by bearing down as if you were going to have a bowel
A passageway is constructed using the appendix so that
catheterization can be done through the abdomen to the
- Bladder Augmentation
Surgical enlargement of the bladder.
See the description of this procedure in the "Spontaneous
Bladder Management -
Urinary Tract Infections