Your urinary tract system is a delicate system that works in conjunction with many parts of the central nervous system. Multiple Sclerosis is a defined as an “unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.”2 With that definition, it’s understandable how Multiple Sclerosis (MS) would impact bladder health. The isolating layer that surrounds the nerves (myelin) is lost and in its place, scar tissues called sclerosis, also known as plaques or lesions are left.3 These lesions are what cause the disruption in communication.
Since the communication between body and brain are disrupted, so are many healthy functions of other internal systems. Some of these functions are more serious than others, but many can be managed with a few lifestyle changes and awareness. In this article, we’ll explore how multiple sclerosis impacts bladder health and what you can do to reduce any associated bladder problems.
Healthy Bladder Function
In healthy adults, your urinary tract system works to produce urine regularly throughout the day. Your kidneys create urine after filtering your blood, then sends it down the ureters and into the bladder. When this is working properly, your bladder slowly starts to fill until nerves are activated, thus sending a signal to your brain that it’s time to use the bathroom. When that occurs, the voiding reflex is triggered which leads to two simultaneous actions.1 The bladder muscles contract to push urine out of the bladder and the external sphincter opens to allow urine to leave the body.1 This continues to happen day-in and day-out, usually without much thought at all.
Bladder Problems in People with Multiple Sclerosis
Unfortunately, most people who have MS experience some sort of dysfunction in this process. If you have MS and are suffering from bladder problems, you’re not alone. At least 80% of people with MS have some sort of bladder dysfunction.1 The reason is that MS creates lesions that block or delay the transmission of nerve signals throughout the central nervous system that work to control the healthy bladder functions we discussed above.1 Depending on where the lesions are, bladder dysfunctions can present themselves in different ways. Multiple Sclerosis can impact bladder health in any of the following ways:
- Urinary Urgency – the scientific term for feeling like you need to pee often and urgently.4 Many people with MS experience urinary urgency where the feelings of needing to use the bathroom are more intense than for someone with healthy bladder functions.
- Urinary Hesitancy – this refers to having problems with beginning your urine stream.4 It’s much harder to start urinating and may take a few minutes each time.
- Incontinence – urinary incontinence is when you lose the control of your bladder altogether.4 If the lesions from MS are in certain areas of your central nervous system, you may not know that you have to use the bathroom until it’s already happening.
- Nocturia – if you have to get up multiple times throughout the night to empty your bladder, you’re experiencing something called nocturia.4
- Neurogenic Bladder – this is the overall term for when someone lacks bladder control due to a brain, spinal cord, or nerve problems.2 The nerves impact how your bladder stores and empties urine, which leads to problems like overactive bladder, incontinence, underactive bladder, or obstructive bladder.2
Diagnosing Bladder Problems
If you notice symptoms of urologic problems such as an increase in hesitancy, urgency, or frequency of urination, it’s important to talk to your urologist. Similarly, if you experience any incontinence issues, give your urologist a call. The only way to properly diagnose bladder problems is with the help of a medical professional. To better understand what is happening, they may do one or more of the following tests.
- Urinalysis
- Urodynamics Testing
- Renal Ultrasound
If you’ve been diagnosed with bladder problems, it’s important to treat them accordingly—regardless of if you have MS or not. Leaving bladder problems untreated can increase your risk for developing permanent, serious damage to your urinary tract. Over time, UTIs will become more frequent, which can lead to kidney and bladder infections. When infections are left untreated, they can cause life threatening side effects such as deadly urosepsis.5
Treating bladder problems will inevitably lead to an increase in your quality of life. Bladder problems can cause damage to personal independence and self-confidence, so don’t be afraid to call your doctor—there are ways to address your problems.1 In people with MS, untreated bladder problems can actually worsen MS symptoms like weakness and spasticity.1 Pay attention to your bladder health and act accordingly to avoid any problems.
Treating Bladder Problems Impacted by Multiple Sclerosis
If you’ve been diagnosed with a bladder problem and have MS, talk to your doctor about your options. Your doctor will likely have you start to address these problems through simple, non-medical changes to your diet, nutrition, and behavior. In most cases, these three things can drastically improve bladder dysfunction in people with MS. If more intensive action needs to be taken, you’ll work closely with your doctor to avoid serious complications.
Diet and Nutrition
The main way to help treat bladder problems impacted by MS is through a few lifestyle changes. What you eat and drink has a big impact on how your urinary tract system functions. To begin, look at your liquid intake. Are you drinking an excess amount of caffeine or alcohol? If so, try cutting back. Limit yourself to one alcoholic drink per day and try to reduce caffeine as much as possible.4 Cut back on processed foods and aim for nutritious meals that have dietary benefits.
Behavior Modification
One of the best things to do to reduce your symptoms is to change your behavior. Even if you don’t realize it, some of your daily habits are likely having a big effect on how your bladder functions. Through bladder training, timed voiding, prompted voiding, and kegels, you can gain back control of your life.
- Bladder Training – works by training your bladder to stretch out and give you longer time between your trips to the bathroom.4 To begin, you’ll want to create a schedule of when you will use the bathroom. You can start by recording your current trips to the bathroom and then create set times based on a rough example of your regular day. From there, if you start feeling like you need to use the bathroom, resist the first urge and refrain from going until you’ve scheduled time to do so.4 This will help you train your bladder to resist frequent trips to the bathroom.
- Timed Voiding – this is similar to bladder training, except you don’t resist the urge to pee.4 Instead, you’ll set a strict schedule of bathroom times and go empty your bladder regardless of if you feel like you need to use the bathroom or not. This will help you empty your bladder regularly and avoid any problems of incontinence.
- Prompted Voiding – this is similar to timed voiding, but with a caregiving reminding someone that they need to use the bathroom. Prompted voiding may not be necessary if you are independent, but is an option for those with more severe cases of MS.
- Kegels – kegel exercises help to strengthen your pelvic floor muscles, which in turn helps you to control your bladder more efficiently.4 Practice doing kegels regularly throughout the day.
Using Absorbent Protection
While you’re changing your behavior or strengthening your pelvic floor muscles, consider using absorbent protection to avoid any embarrassing accidents. This will help you take your behavior modification as far as possible, which will strengthen your bladder function over time.
Medications
If you’re still having problems after behavior modifications, talk to your doctor about using medication. There are a number of FDA-approved medication available to help with both bladder control and behavioral training.4 Never take any medication without consulting your doctor first.
Mechanical Aids or Surgery
Finally, if you’re still having problems, your doctor may recommend using intermittent self-catheterization to help empty your bladder. There is also the possibility of using a urethral insert or an external urethral barrier. As a very last resort, after exhausting all other treatment options, surgery can be discussed.
Conclusion
Living with MS is difficult enough, you don’t have to endure problems with bladder dysfunction as well. If you notice any signs or symptoms of bladder problems, call your urologist as soon as possible. You’ll work side-by-side to diagnose your problem and come up with a treatment plan that will help you get your life back. If you need any urological supplies or additional educational resources, visit our educational support page or our product selection guide. Byram Healthcare is proud to offer full-service urological care and we have all the high quality urological supplies that you need. All of your orders can be discreetly delivered to your home, at any time of the day. If you’re looking for personalized, confidential services, our teams of knowledgeable urological customer service specialists are here to help.
Sources:
1 https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Bladder-Dysfunction
2 https://www.urologyhealth.org/careblog/how-multiple-sclerosis-impacts-bladder-health
4 https://www.webmd.com/multiple-sclerosis/bladder-control-problems#1
5 https://www.verywellhealth.com/bladder-dysfunction-and-multiple-sclerosis-2440800
