These distressing problems may complicate some of the more severely affected patients. Sphincters may remain closed leading to retention of urine, which eventually leaks out due to overfilling of the bladder. Such a condition often gives the appropriate stimulus for flexion withdrawal and may increase flexor spasticity. The recumbent position added to urine retention may lead to back pressure into the kidneys with further complications.
It is always wise to allow such patients to adopt a vertical position periodically to relieve this effect. Incontinence of urine may lead to skin breakdown since, inevitably, the skin will become soggy and more vulnerable. Some patients may develop ‘automatic’ bladder-emptying mechanisms but others may have to have some permanent help in the management of the problem. There may also be problems related to defecation although these can often be managed by…
