Incontinence after a slipped disc

Introduction

Incontinence after a slipped disc is a typical, but not necessarily frequent phenomenon. Irritation or damage to nerve fibers caused by the herniated disc are the reason for this. The degree of incontinence can also vary in severity and does not necessarily mean that you can no longer hold your water. Often there are only a few drops.

Why can a slipped disc in the lumbar spine lead to incontinence?

The continence of the human urinary bladder is based on a complex interaction of voluntary and autonomous muscles. Furthermore, the filling state of the bladder, the activity level of the sympathetic and parasympathetic nervous system play a major role in the retention of urine. All these components are controlled and supplied by nerves that make their way to the bladder or from the bladder to the brain via the spinal cord.

The herniated disc in the lumbar region now ensures that certain of these fibre connections between the bladder and brain are disrupted or, in the worst case, even destroyed. The transmission can therefore no longer function without problems. As a rule, incontinence is a combination of the failure of the arbitrarily controllable musculature – namely the pelvic floor and bladder muscles, which are controlled by the sympathetic and parasympathetic nervous systems, the so-called autonomic nervous system.

The pelvic floor muscles, which can be consciously tensed, serve to consciously close the urethra. Anyone who has ever had to urinate urgently knows the feeling that the body actually sets all its signals to “let it go”, but you can still hold it back by tensing the pelvic floor muscles strongly. If the nerve connections to the pelvic floor muscles are disturbed, it may no longer be possible to keep to these critical situations.

In order to avoid a permanent tension of the pelvic floor, the vegetative nervous system – sympathetic and parasympathetic – normally takes over. They control an occlusive muscle of the urethra, which is located slightly above the pelvic floor. Normally this muscle is contracted – completely unconsciously for the human being – and thus blocks the way to the urethra.

The muscles of the bladder are relaxed. However, when the bladder reaches an individually limited filling level, pressure sensors from the bladder send signals to the brain. The human being experiences this as an urge to urinate.

If the person decides to give in to the urge to urinate or if the bladder is too full, the autonomic nervous system starts working again. The occlusive muscle of the urethra widens and clears the way through the urethra to the pelvic floor. In addition, the muscles around the bladder begin to contract – it is virtually wrung out.

If the decision to relax the pelvic floor is taken arbitrarily, the urine can pass through the entire urethra and is excreted. So it’s obvious that there are a number of possibilities that can result in incontinence if the bladder is disturbed. Depending on where the spinal cord or the exiting nerves were damaged and how severe the damage was.