Multiple sclerosis (MS) is a condition where the immune system damages myelin, the substance that protects nerve fibres in the central nervous system. This causes lesions to disrupt the signals between the brain’s central nervous system(CNS) and different parts of the body.
When communication between the brain’s central nervous system and the body’s bladder gets delayed or disrupted, the patient may have an overactive bladder, an underactive bladder, or both. That is MS bladder problems or Neurogenic Bladder.
90% of people with MS experience bladder dysfunction throughout the course of the disease. The bladder dysfunction makes it hard to release or store urine properly in the bladder. The symptoms of bladder dysfunction may vary depending on the patient. As a result, the patient may feel less confident, and expert support can help them regain independence. In this article, we’ll explain the causes, symptoms, treatment, and management of bladder issues in MS patients.
What Causes MS Bladder Problems?
The bladder should receive signals from the brain’s CNS nerves to work properly, to empty the bladder, or to hold urine until you are ready to empty it. This connection between the brain and bladder is crucial to control when you pass urine.
Disruption in this signal can cause the muscles controlling urine retention and release to not function properly. As a result, the bladder muscles may not hold the urine well or empty the bladder completely. This can lead to urine leakage, commonly called incontinence.
Two key muscles regulate urination:
- Detrusor muscle: It contracts to push urine out of the bladder and store it.
- Sphincter muscle: It relaxes to allow urine to pass through the urethra
When nerve pathways are damaged, these muscles may not work, causing MS bladder problems such as
- Hyperactive bladder: A storage dysfunction where the bladder becomes overactive with urgency and frequent visits to the bathroom.
- Hypoactive bladder: An emptying dysfunction where a person has a problem with starting urination and leaving residual urine in the bladder.
- Combined dysfunction: Problem with both the dysfunctions, emptying and storage problems.
The bladder issues may cause varying symptoms in people depending on the intensity of the problem. In the next section, let’s understand these symptoms.
Identifying Bladder Symptoms and MS
MS affects every person differently, with symptoms changing over time. These can disrupt the routine of life and impact mental peace. However, identifying these symptoms is the first step towards better management of the condition. The most common MS bladder symptoms include:
- Urgent feeling to urinate
- Passing urine often
- Nocturia
- Hard to urinate when the bladder is full
- Incomplete bladder emptying
- Urinary tract infection
- Leaking urine
- Kidney stones
- Bladder damage
- Kidney infection
It can be frustrating when patients experience one or more of these symptoms. But tailored help can make a real difference. When these symptoms are identified, the best course of action is to seek appropriate treatment options. With constant support and professional help, it’s possible to regain bladder control in MS patients.
Effective Treatment Options for MS Bladder Issues
It is important to gain control over your bladder, especially when you have MS. These also help in protecting kidney health. Here are some of the medical treatments that may be used to recover from bladder:
Behavioural therapies
Behavioural therapies aim to establish a routine so that the signals from the brain can be potentially regulated. Starting these small routines can help the patients rebuild trust in their own bodies. Some of the ways to create this routine are:
- Bladder training: Time your toilet visits, and increase the interval between visits.
- Scheduled voiding: Empty your bladder at the same time everyday, and time.
- Fluid management: Monitor your water and fluid intake.
Pelvic floor exercises
Pelvic health therapy restores muscle and postural dysfunction, which helps bladder health. Some patients may find relief with these non-invasive methods. When the muscles that control urine release are strengthened, the patient may be able to reduce urinary incontinence and pain during urination or defecation. It may also help with urinary retention.
Medication
Depending on the patient’s needs, certain medications are available to help with the urinary bladder symptoms. Some of the options are:
- Anticholinergics: to relax an overactive bladder
- Botox: Injection when anticholinergics do not work
- Bethanechol: To stimulate an underactive bladder
- Antibiotics: To control any bladder infection
Don’t take these without the advice of a doctor.
Catheterisation
When you have an underactive bladder, catheterisation is a therapy used. In this one, a small tube is inserted into your urethra to help empty your bladder fully. There are two types of Catheterisation:
- Clean intermittent catheterisation (CIC)
- Continuous catheterisation
Tibial Nerve Stimulation
Percutaneous Nerve Stimulation, or PTNS as it is commonly known, is a treatment that directly stimulates the nerves responsible for bladder and bowel control and is a method that can be used to treat incontinence. Some MS patients have found this helpful.
Some of the treatment options require continuous care and management. Improvements may be noticed gradually. Learning the day-to-day management of bladder control is crucial for patients to recover.
Daily Management Tips for Better MS Bladder Control
Care providers may offer a combination of the above treatment options. Following professional advice for bladder control is essential. Simple daily habits can reduce stress and allow patients to continue with their daily routine. The following tips can help with better bladder control:
- Change your diet and meals according to the symptoms and bladder problems
- Bladder training or planned voiding can help reduce urine leakage incidents
- Avoid smoking and limit alcohol, caffeine, etc.
- Do not drink less fluid to avoid bladder symptoms: Inadequate hydration can cause infections and constipation.
- Limit fluid intake in the evenings to avoid frequent night urination.
While daily management can help with mild bladder issues, patients with severe urinary control problems must approach healthcare providers.
When to Speak to a Healthcare Professional
MS Bledder problems should never be neglected if bladder problems have changed or worsened, such as urgency, leakage, or difficulty urinating. It is important to consult a healthcare professional promptly.
Medical assessment may include:
- A physical examination, digital rectal examination, and pelvic measurements.
- Measurement of residual urine after emptying the bladder
- Urodynamic testing to evaluate bladder function
Early intervention can prevent complications such as recurrent infections or kidney problems. Specialists such as neurologists, urologists, and continence nurses can work together to create a personalised treatment plan.
Compassionate Multiple Sclerosis Care in Wolverhampton
People with MS bladder issues require support, which includes lifestyle management assistance, together with medical care, and ongoing help. Professional care services offer management support that preserves patient dignity and helps them stay comfortable throughout the treatment.
Trained carers can assist with continence support, medication management, mobility assistance, and daily routines tailored to the individual needs of people with MS. Multiple Sclerosis Care in Wolverhampton provides specialised services that deliver personalised support together with compassionate help to improve the daily lives of patients.
