Bladder and Bowel Continence for Individuals with Spina Bifida

If you or someone you love is dealing with continence issues related to spina bifida, you are not alone! At Hydrocephalus Canada, we can connect you with information, support and others who are willing to share their ideas, experiences and lessons learned about bowel and bladder management. Knowledge is power. We understand that these are sensitive and difficult issues to discuss and they can greatly impact health, social and emotional well-being. We can help!

Achieving bowel and bladder continence for individuals with spina bifida is a vital part of staying healthy and being independent. Not having control of your bowel and bladder can have a great impact on your life. Both need to be monitored by a health care provider and assessed throughout your life. It is a major goal that children, parents, adults and health care providers always hope to reach, however, getting there can be challenging.

Most individuals with spina bifida do not have intact nerve pathways in the spinal cord to signal a bowel movement or that their bladder is full and needs to be emptied.  This is referred to as a neurogenic bowel/bladder.

This section of the website will provide information to assist parents and adults to work with their health care professionals to manage bowel and bladder continence. 

BLADDER CONTINENCE    

Most individuals with spina bifida will have bladder function issues due to nerve damage which interrupts the messages between the bladder, sphincter muscles, spinal cord and the brain.  The amount of damage and bladder control varies depending on the location of the lesion.  A bladder management program is also based on individual needs and which methods work best. 

The priority and goal is to preserve kidney function as long as possible and manage urinary continence.  A bladder that does not work normally might not empty properly and urine may flow back into the kidneys leading to urinary tract infections (UTIs) and other life threatening issues.

Canadian nurses no longer
support the re-use of intermittent catheters

We care about your health and well-being and we want to let you know about an important change to Canadian clinical recommendations for intermittent catheter use. As of 2020, Canadian nurses no longer support the re-use of intermittent catheters.1Instead, Canadian urologists and nurses recommend single use intermittent catheters, ideally those that are hydrophilic or pre-lubricated.1,2

Keep your bladder healthy

UTIs are a constant concern for catheter users.3 The new Canadian recommendations for catheter use recognize this, and work to help Canadian catheter users keep their bladder healthy.

Re-using intermittent catheters causes unnecessary bacteria contamination, which may result in urinary tract infections
(UTIs).4,5

Single-use hydrophilic or pre-lubricated catheters are recommended because they appear to lower the risk of UTI, may result in less urethral trauma, and have a higher convenience and ease of use compared to conventional uncoated catheters.2*

The Coloplast Care team can help you explore your reimbursement options

Product reimbursement in your province can be complex and overwhelming. The Coloplast Care team can help you identify where to apply to get coverage for your catheters. The Care team can also help you follow the necessary steps, and can provide the Coloplast Letter of Recommendation to you. The letter can provide additional support for your claim, by giving providers a rationale as to why you need a specific catheter.

For more information please contact us at 1-866-293-6340 or at [email protected]

*findings not specific to Coloplast catheters
1. Clean Intermittent Urethral Catheterization in Adults – Canadian Best Practice Recommendations for Nurses. Developed by Nurses Specialized in Wound, stomy and Continence Canada, Canadian Nurse Continence Advisors, Urology Nurses of Canada, and Infection Prevention and Control.1st Ed.
2020.
2. Can Urol Assoc J 2020;14(7):E281-9. http://dx.doi.org/10.5489/cuaj.6697
3. Coloplast Market Study_IC Research_2015_Data on file
4. Bogaert GA, Goeman L, de Ridder D, Wevers M, Ivens J, Schuermans A. The physical and antimicrobial effects of microwave heating and alcohol immersion on catheters that are reused forclean intermittent catheerisartion. Eur Urol. 2004;46(5):641-6
5. Chan JL, Cooney TE, Schober JM. Adequacy of sanitization and storage of catheters for intermittent use after washing and microwave sterilization. J Urol. 2009;182(4 Suppl):2085-9

COLOPLAST CANADA Sponsored content

Le personnel infirmier canadien n’est plus favorable à la pratique de réutilisation des cathéters intermittents

Votre santé et votre bien-être nous tiennent à cœur. C’est pourquoi nous souhaitons vous faire part d’une importante modification des lignes directrices canadiennes en matière d’utilisation des cathéters intermittents. Depuis 2020, le personnel infirmier canadien n’est plus favorable à la pratique de réutilisation des cathéters intermittents1.

Les urologues et le personnel infirmier canadiens recommandent plutôt l’usage unique des cathéters intermittents, spécifiquement les cathéters à revêtement hydrophile ou prélubrifiés1,2.

Maintenez la santé de votre vessie

Les IVU sont une préoccupation constante pour bon nombre d’utilisateurs et d’utilisatrices de cathéters3.  Les nouvelles recommandations canadiennes relatives à l’utilisation des cathéters en tiennent compte et sont revues pour aider les utilisateurs canadiens à maintenir la santé de leur vessie.

La réutilisation des cathéters intermittents entraîne des risques de contamination bactériologique, ce qui peut causer des infections des voies urinaires (IVU)4,5.

Les cathéters hydrophiles à usage unique ou prélubrifiés sont recommandés, parce qu’ils semblent réduire les risques d’IVU, éviter les dommages urétraux et s’avèrent plus pratiques et faciles à utiliser en comparaison avec les cathéters classiques non lubrifiés2.*

L’équipe Coloplast Care peut vous aider à explorer les options de remboursement qui s’offrent à vous

Le remboursement du produit dans votre province peut être complexe et fastidieux. L’équipe Coloplast Care peut vous aider à trouver une assurance pour vos cathéters. L’équipe Care peut également vous aider à suivre les étapes nécessaires et vous remettre la Lettre de recommandation de Coloplast. Motivant la raison pour laquelle vous devez utiliser un certain type de cathéter, la Lettre de recommandation de Coloplast vient appuyer votre demande de remboursement auprès des fournisseurs.

N’hésitez pas à communiquer avec nous par téléphone au numéro sans frais 1 (866) 293-6340 ou par courriel à l’adresse [email protected].

*Résultats non spécifiques aux cathéters de Coloplast.

  1. Clean Intermittent Urethral Catheterization in Adults – Canadian Best Practice Recommendations for Nurses. Developed by Nurses Specialized in Wound, stomy and Continence Canada, Canadian Nurse Continence Advisors, Urology Nurses of Canada, and Infection Prevention and Control.1st Ed.
    2020.
  2. Can Urol Assoc J 2020;14(7):E281-9. http://dx.doi.org/10.5489/cuaj.6697
  3. Coloplast Market Study_IC Research_2015_Données consignées.
  4. Bogaert GA, Goeman L, de Ridder D, Wevers M, Ivens J, Schuermans A. The physical and  antimicrobial  effects  of microwave heating and alcohol immersion on catheters that are reused forclean intermittent catheterisartion. Eur Urol. 2004;46(5):641-6.
  5. Chan JL, Cooney TE, Schober JM. Adequacy of sanitization and storage of catheters for intermittent use after washing and microwave sterilization. J Urol. 2009;182(4):2085-9.

COLOPLAST CANADA Contenu sponsorisé

 

 

Our partner in bladder health, Coloplast Canada, has some great information on avoiding urinary tract infections: 

How to Avoid a Urinary Tract Infection
Comment Eviter Les Infections Urinaires

 

Regular visits to a urologist is paramount.  These visits could include various tests to monitor your bladder and kidneys such as a renal and bladder ultrasound, renal scan, intraveious pyelogram (IVP), voiding cystourethrogram, urodynamics, cystoscopy and urine tests.

The Neurogenic Bladder

drawing of bladder and kidneysPeople with spina bifida, particularly the myelomeningocele form, “have impaired autonomic [nerve] function and may therefore have absent or minimal sensation of bladder fullness and an inability to initiate the voluntary, coordinated process of urination.” (Sandler, Adrian (1997). Living With Spina Bifida, A Guide for Families and Professionals, University of North Carolina Press, p.25). Autonomic nerves are responsible for transmitting messages from organs to the brain. In this instance, the message that your bladder is full does not get properly sent to the brain. Also, the nerves that control voluntary muscles like the urinary sphincter and the relaxation and contraction of the bladder itself don’t work properly. This miscommunication between your brain and bladder can cause several problems including:

  • lack of control of urination
  • Incomplete emptying of the bladder
  • Increased pressure that can lead to complications such as urinary tract infections, reflux (urine forced back up towards your kidneys) and kidney damage.

Proper management can help avoid these problems that can lead to life-threatening issues! There are too many tragic stories to sit back and do nothing. Bladder infections and other problems are serious and need to be treated quickly.

How Does the Bladder Work?
Comment la vessie fonctionne-t-elle?
SB and Bladder Function

Urinary Continence Programs/Methods:

  • Clean Intermittent Catheterization (CIC)
  • Other types of catheters-condom catheter, indwelling foley catheter, suprapubic catheter
  • Medication
  • Crede technique (pushing on bladder with your fingertips)
  • Urinary diversions-ileal-conduit, continent stoma, vesicostomy, Mitrofanoff procedure
  • Surgical intervention-bladder augmentation, sphincter tightening
  • Biofeedback and electrical stimulation
  • Botox treatments

An effective bladder program will reduce common problems such as UTI’s, overfull bladder, bladder and kidney stones, reflux, hydronephrosis and bladder accidents. Even the food you eat and what you drink can make a difference in the health of your bladder. 

HEALTHY FOOD AND BLADDER ISSUES
ALIMENTATION SAINE ET TROUBLES URINAIRE

 

Our partners at COLOPLAST CANADA have compiled a list of FREQUENTLY ASKED QUESTIONS about bladder problems.
QUESTIONS FRÉQUEMMENT POSÉES SUR LES TROUBLES DE LA VESSI

 

 

BOWEL CONTINENCE

Most people living with spina bifida will experience bowel issues related to having what’s called a neurogenic bowel (explained in detail below). Each person’s bowel program is based on individual needs and which methods work best for you. To manage bowel continence you may need to explore a variety of options before you find the right fit for you. A good bowel program aims to keep stool firm, empty the bowel at a specific time daily or every few days and not to have any bowel accidents.

The Neurogenic Bowel

frawing of impacted bowleMost individuals with spina bifida will have common bowel problems related to the damage to the nerves responsible for the sensation of bowel fullness and emptying. Constipation, impaction, diarrhea and bowel accidents are all possible. Signs of bowel problems can include hard stool, no stool, poor appetite, abdomen is enlarged and feels hard, blood in the stool or loose stool that leaks around the hard stool.

Exercise, drinking plenty of fluids and eating a healthy diet high in fiber can help in achieving a bowel program that works for you.

If a bowel management program is not effective, surgical treatments are available. 

HOW THE BOWEL WORKS (Coloplast Video)
VOUS-SOUFFREZ DE TROUBLES COLORECTAUX
UNDERSTANDING BOWEL FUNCTION

 

Bowel Management Programs/Methods:

  • Habit training
  • Digital stimulation
  • Disimpaction
  • Stool softeners and bulk formers
  • Suppositories
  • Laxatives
  • Enemas, fleets and enema continence catheters
  • Diet and exercise

Exercise, drinking plenty of fluids and eating a healthy diet high in fiber can help in achieving a bowel program that works for you. 

WHY IS BOWEL CARE SO IMPORTANT?

If a bowel management program is not effective, surgical treatments may be needed.  These may include the MACE (Malone Antegrade Continence Enema), cecostomy/c-button procedure or a colostomy. 

 

Our partners at COLOPLAST CANADA have compiled a list
of FREQUENTLY ASKED QUESTIONS about bowel problems.
VOUS SOUFFREZ DE TROUBLES COLORECTAUX 

 

We are happy to welcome COLOPLAST CANADA as our new partner
in providing information on bowel and bladder health.