Brain Injury: Bladder Care

Brain Injury: Bladder Care 


Causes of bladder problems

Bladder function is controlled by the brain. Brain injury may cause bladder problems, such as:

  • Incontinence: Not being able to control when the bladder empties of urine or not being aware of the need to use the toilet.
  • Retention: Not being able to fully empty the bladder of urine. 

Work with your doctor and nurse to create a daily bladder care program to improve bladder control and reduce your risk of urinary tract infection (UTI). 

  • Signs of UTI include: pain or burning when you urinate, fever, an urge to urinate often, pressure in your lower belly, urine that smells bad or looks cloudy or reddish, and pain in your back or side below the ribs.

Bladder care program

  • Keep a record of when and how much you urinate. 
  • Have a routine. Use the toilet or bedside commode at regular times, at least every 2 to 4 hours during the day and night. Use the toilet before therapy and exercise.
  • If your skin gets wet from urine, wash it with soap and water and rinse well. Keep skin clean and dry to prevent skin irritation, and sores.
  • After bathing, use a moisturizer and a barrier cream, such as petroleum jelly, zinc oxide, or diaper cream, to keep water and urine away from the skin. 
  • Drink plenty of fluids, at least eight, 8-ounce glasses a day, to help wash out bacteria out of the urinary tract and prevent infection. Water and cranberry juice are helpful. 
  • Do not drink anything 2 to 4 hours before bedtime. Empty your bladder before bedtime to prevent an accident at night.
  • Talk to your doctor or nurse about taking medicines to help.

Incontinence

  • Use the toilet or bedside commode at regular times, at least every 2 to 4 hours. 
  • Look at your record of how often you urinate. See if there is a common time of the day that incontinence occurs. Use the toilet 30 minutes before that time.
  • Practice your rehab exercises to improve pelvic muscle tone.
  • Talk to your doctor or nurse about using urinary incontinence products, such as pads and adult diapers. Change these regularly, even if you are dry, to keep your skin healthy. You may also want to use washablewaterproof pads over sheets and on chairs to protect furniture. 
  • Patients may use external catheters to collect urine.

Retention

  • Take prescribed medicine as ordered by your doctor.
  • Nursing staff may use a bladder scanner to assess your post-void residual (PVR). This measures the amount of urine left in your bladder after urinating. 
  • Use intermittent catheterization, also called self catheterization or straight cath, if ordered by your doctor. This type of tube is put into the bladder only long enough to drain urine. Once the bladder is empty, the tube is removed. 
     

© 2000 – November 1, 2023, The Ohio State University Wexner Medical Center

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. For more health information, call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.