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Warning-sign checks

Neurogenic bladder: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Go to emergency care for new loss of bladder control or urinary retention together with severe back pain, new leg weakness, numbness around the buttocks or genitals, or loss of bowel control.

    These can be signs of pressure on the cauda equina nerves and require immediate assessment.

    This is an emergency.

    If trained to do so, sit upright and check the catheter for kinks while emergency help is being arranged.

    And for anyone, someone who:

    • has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek urgent medical help if you cannot urinate and your lower abdomen is becoming painful or swollen.

    Prompt treatment is also needed for fever with pain in the side or back, vomiting, confusion, or feeling significantly unwell, as these can occur with a kidney infection or blocked urinary drainage.

    And for anyone, someone who:

    • has a new severe headache unlike any they have had before
  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a routine medical review if you develop new leakage, increasing urgency, difficulty emptying, repeated infections, catheter problems, blood in the urine, or a clear change from your usual bladder pattern.

    Also seek review if your current plan is difficult to manage or is limiting daily activities.

The article also says

People with a spinal cord injury, especially at or above the T6 level, can develop autonomic dysreflexia from a full bladder or blocked catheter.

Warning signs include a sudden pounding headache, heavy sweating or flushing above the injury, goosebumps, blurred vision, anxiety, or very high blood pressure.

Every sign above is quoted from the sofidex article on Neurogenic bladder. If you are not sure, err upward — it is always reasonable to be checked.