We don’t often think about it unless there is a problem. But urinating is a complex process. In addition to the involvement of the urinary system, the brain stem, spinal cord and cerebral cortex support this function. Voluntary and involuntary muscles are also recruited to hold urine and empty the bladder. Traumatic brain injury leads to incontinence when involved systems are compromised.
How the brain is involved
When urine is in the storage phase (being held in the bladder) the brain and bladder work together to sense fullness. In healthy individuals, the bladder holds the urine in until the brain signals that it is time to void (or urinate). Although the bladder may send the brain a signal that it is time, the brain can inhibit urination if you’re, say, stuck in traffic until it is convenient.
Once the brain sends a signal that it is time to void, urination begins until the bladder is empty.
TBI and UI
Urinary incontinence is quite common with traumatic brain injury, particularly in the first several weeks. Injury to the frontal lobes causes loss of cortical control of urination. Without management or treatment, leaks and accidents occur. Urinary retention, or difficulty emptying the bladder, can also result from traumatic brain injury.
Traumatic brain injury can disrupt communication between the brain and bladder. TBI related damage to bladder perception and sphincter control essentially does away with or extends the storage phase. Urination happens involuntarily, almost as soon as it enters the bladder. The bladder may empty too often and without warning or hold urine even when the bladder is full.
Rehabilitation and UI management
Your medical team will develop a rehabilitation plan to restore as much healthy urinary function as possible. Healing takes time. It is important to be patient and realistic about what you can expect. In the meantime, speak openly with your providers about how incontinence impacts your daily life.
Recent advances have made more surgical and therapeutic options available. Innovative incontinence products such as the Men’s Liberty external collection system can also free you from some of the limits of incontinence. An alternative to the traditional catheter our device protects the skin and keeps you dry up to 24 hours – even while you sleep. It’s easy to use, too.
Give us a call today to learn how we help men manage incontinence with dignity.