Multiple Sclerosis and Bladder Function
For many people, living with MS means coping with decreased bladder function. That's because an MS lesion in the brain or spinal cord can block the signal from the nervous system that controls bladder muscles and the urinary sphincters that regulate the urine stream. This can create problems with either urine storage or emptying. People who cannot fully empty their bladders are at a higher risk for developing a urinary tract infection (UTI).
Symptoms, Tests and Treatments
Determining with your healthcare provider what type of bladder dysfunction you have is usually straightforward. The most common method is to measure how much leftover or residual urine is in the bladder after it is emptied. This can be done either by inserting a catheter, removing the residual urine and measuring, or by taking images of the bladder using an ultrasound. In both cases, if the residual amount is less than 100ml, the problem may be storage. If it is greater than 100ml, the problem may be incomplete emptying.
Potential symptoms include:
- Frequency
- Urgency
- Dribbles
- Incontinence
- Nocturia
- Difficulty starting to void
People with MS can help take control of their bladder function by taking certain medications as prescribed, being aware of their surroundings, and planning ahead. In some cases, your doctor may recommend Kegel exercises, or suggest using incontinence pads or catheters.
Typically, your neurologist will try several ways to treat bladder dysfunction; however, if he or she is unsuccessful, you may be referred to a urologist.
Start the Discussion
Discussions about MS and bladder issues with your neurology team don't have to be awkward if you are open and honest. They hear about it all the time. Perhaps some of the awkwardness stems from just getting started on the topic with your doctor. Some people find it easier to bring their concerns up with the nurse, first. That can lay the groundwork for the doctor to address the issue in a way that is more comfortable for you.
