As frustrating and embarrassing as the symptoms may be, it’s important not to ignore them. There are many medical treatments available today that can improve urinary function, while simple dietary and lifestyle measures can help you better manage the condition, often with minimal stress or impact on your life.
Causes
Multiple sclerosis is characterized by an abnormal immune response that causes damage to the protective covering of nerve cells (myelin sheath). This damage results in the formation of lesions on the brain and/or spinal cord which, in turn, interfere with the nerve impulses that regulate movement, vision, sensations, thought processes, and bodily functions like bladder control.
Bladder dysfunction in MS happens when electrical signals to the bladder and urinary sphincter are delayed or obstructed by lesions that develop on the spinal cord.
Dysfunction can occur for three reasons:
Signs and Symptoms
The symptoms of bladder dysfunction can vary by the extent and location of the lesions. In some cases, the symptoms will be mild and transient. In others, they may be persistent and aggravating.
Urinary symptoms can present in one or more of the following four ways:
Complications
If bladder dysfunction is left untreated, it can cause permanent damage to the urinary tract. Urinary stones and urinary tract infections (UTIs) can often develop if the bladder is unable to empty. Chronic leakage can also lead to localized skin infections. In severe cases, potentially deadly urosepsis may develop if a urinary infection spreads into the bloodstream.
It’s also important to note the impact of bladder dysfunction on a person’s peace of mind and lifestyle. It is not uncommon for people with bladder control problems to isolate themselves or restrict their daily routines, often adding to the burden of depression frequently seen in people with MS.
Diagnosis
When investigating bladder dysfunction, healthcare providers will ask you about your symptoms. They will want to rule out a UTIs by testing your urine.
If positive, antibiotic treatment will be prescribed. If not, other tests (known as a urodynamic assessment) will be performed to evaluate how well the bladder and urethra are storing and releasing urine.
A urodynamic assessment takes around 30 minutes and involves the use of a small catheter to fill the bladder and record measurements.
Treatment
As distressing as bladder dysfunction can be, urinary symptoms can usually be managed successfully with medications, lifestyle modifications, and other therapies.
Treatment will be determined by the specific cause of the dysfunction:
Other forms of treatment include behavioral therapies which teach people how to regulate fluid intake and strategically schedule urination while at home, work, or social engagements.
Dietary strategies include the restriction of caffeine, alcohol, and orange juice (the latter of which promotes bacterial growth) and the use of cranberry juice or tablets (which inhibit bacterial growth).
More severe cases may require surgical procedures, including an electrical implant, called an InterStim, which stimulates the sacral nerves and helps treat an overactive bladder. Botox can also be used to treat an overactive bladder.
A Word From Verywell
Having bladder problems can be upsetting, but the sooner you tell your healthcare provider, the sooner you will receive proper treatment and be able to resume your normal activities without worrying about leaks or frequent trips to the bathroom. Our Healthcare Provider Discussion Guide below can help you start a conversation with your practitioner about the specific symptoms you may be experiencing.
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