Individuals with high intravesical pressures and impaired bladder compliance are more prone to UTIs than those with low intravesical pressure and high-capacity bladder that it is emptied periodically by IC.¹

What is the explanation for patients’ bladder problems?

With any spinal cord injury, the disruption of the normal somatic and autonomic neurological control of bladder causes bladder dysfunction. If the injury is in the suprasacral area, a micturition reflex may emerge after the acute phase to cause bladder overactivity. Sometimes, ineffective bladder emptying and large postvoid residual volumes may also occur.²

Lesions in the lumbosacral area may cause bladder inefficiency with bladder overfilling and voiding inability. Many neurogenic patients have bladder dysfunction - it is very common in MS, and if disease duration is above 10 years, up to 80% of the MS patients have bladder symptoms.²

Why is impaired bladder compliance a problem?

The degree of bladder dysfunction, assessed through urodynamic parameters, appears to correlate to increased UTI incidence rates.³

What do we know from the evidence?

In a retrospective study, low bladder compliance, bladder overactivity, and urine backflow correlated with increased UTI incidence rates in 76 spina bifida patients performing CIC.³ A recent retrospective study including 194 spina bifida children could not verify a correlation.⁴

Experience from clinical practice supports a correlation between UTIs and poorly compliant bladder.⁵ A decreased blood flow causing bladder ischemia may predispose to UTI. This happens in relation to an increased pressure inside the bladder and overdistension due to large urine volumes.⁶