Paraplegia causes interruption of normal nerve impulses to both the bladder, where urine is stored, and the intestines. According to the caregiver resource Sci-Info-Pages, paraplegics generally need to use either an internal or external urinary catheter for urination and maintain a bowel management program to prevent accidentally having a bowel movement at a socially unacceptable time.
According to Sci-Info-Pages, paraplegics generally have either a flaccid or a hyperactive bladder. In the former instance, the bladder muscle has no tone and easily becomes over-stretched. People with a flaccid bladder must empty it manually, either by inserting a catheter into the bladder intermittently or by manually pressing on the bladder, a technique known as credé. Practicing the Valsalva maneuver, which involves bearing down as if to have a bowel movement, empties the bladder for some individuals as well.
Those with a hyperactive bladder generally have the opposite experience, says Sci-Info-Pages. That is, the bladder empties spontaneously whenever it becomes full. Most men with this issue wear an external device, such as a condom catheter, to collect urine. However, women generally require an indwelling catheter inserted through the urethra or through the skin above the pubic bone (a suprapubic catheter). For some people, medication or surgery may restore a measure of bladder control.
Bowel care is another major concern for people with paraplegia. According to Apparelyzed, a peer support website for paraplegics, most paraplegics maintain bowel control through a regimen involving daily or every other day digital stimulation, dietary management, medication and careful attention to their routine.