tube to be just tucked away in a swimsuit or under clothing. I wished thesehad been made available to me at the
same time I started using thesuprapubic catheter, as I feel I would probably have used the leg bag less,and the spigots more.
Jean, T10/11 complete
Care should be taken when using a catheter valve or spigot if you easily developautonomic dysreflexia.
Warning signs of a full bladder
Training also involves learning to recognise the signs that your bladder needsemptying. These will vary depending on the level of your lesion, but may includebackache, abdominal fullness and, in high lesion paraplegics and tetraplegics,headache, sweating, flushing of the face, neck and shoulders and goose pimples.
In tetraplegics and paraplegics with lesions at T6 or above, an overfullbladder, or a bladder that is generating high pressure during passing water, are thecommonest causes of autonomic dysreflexia, a sudden and potentially life-threatening surge in blood pressure. It is vital that you know how to recognise thesigns of this and take appropriate action
Given the difficulties with continence, it may be tempting to drink less fluid. This is amistake, especially if you use an indwelling catheter: you need a good fluidthroughput to keep your kidneys clean and bladder washed out and functioningproperly. If you are prone to urinary tract infections, then increase your fluid intake(preferably to at least 3 litres or 5 pints per 24 hours), make sure your urine isslightly acid and if necessary take vitamin C (but not the effervescent type) or drink cranberry juice to increase the acidity. Some people also take urinary antiseptics inconjunction with Vitamin C to maximise its effects.
It is essential that your bladder is emptied regularly (preferably every 3–4 hoursduring waking hours) and as completely as possible. An overfull bladder may causeurine to reflux or ‘back up’ into your kidneys and can cause infection and damage. Intetraplegics it can cause autonomic dysreflexia
. Inadequate emptying of thebladder causes sediment and deposits to build up, increasing the likelihood of infection and bladder stones.
Make sure that your toilet at home is well adapted for you: easy to get in and out of,with hand rails in the right place, a handbasin at a suitable height, a padded toiletseat (important to avoid pressure sores), a low shelf or work surface and thesupplies you require within easy reach. If you are able to use one, a bidet can be agodsend. Alternatively, there are special combined toilet/bidets
Take carethat the water is not too hot.