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WebMD tells us that bladder control problems occur in at least 80% of people with multiple sclerosis. Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying the bladder can become disrupted.
These problems can seem overwhelming, and often embarrassing. But, there are steps you can take to manage bladder control problems.
Those with multiple sclerosis can experience the following bladder control issues:
• Urinary urgency. People with this problem feel the need to urinate frequently and urgently. The small “tickle” and feeling of pressure that help us recognize the right time to head to the restroom is very intense. When urinary urgency takes place, the signals that coordinate urination are disrupted and you experience this uncontrollable urge to urinate which can cause incontinence.
• Incontinence. This is the loss of bladder control. Sometimes MS will disrupt the nerve signals sent to the body parts that control urine movement allowing urine to come out involuntarily.
• Nocturia. People with nocturia must awake frequently during the night to go to the bathroom. There are a number of causes for this type of incontinence, but persons with MS may experience nocturia due to the interruption of brain impulses that travel up and down the spine to coordinate urination.
• Urinary hesitancy. This refers to difficulty initiating urination. With multiple sclerosis, this problem may be caused by interruption of brain impulses that control that part of the urination process.
What Happens if a Bladder Control Problem Goes Untreated?
If left untreated, bladder control problems can cause other health concerns, including:
• Repeated urinary and bladder infections or kidney damage
• Personal hygiene problems which can be avoided with proper care
• Interfering with normal activity and leading to isolation but like I said with care, can be evaded
How Are Urinary Control Problems Treated in Multiple Sclerosis?
For those with multiple sclerosis, treatment of urinary control problems is individualized. Many times a doctor who specializes in treating incontinence, called a urologist, will be involved in your care. Your doctor may recommend one or more of the following:
• Dietary changes to minimize incontinence
• Behavioral changes
• Mechanical aids to help control the flow of urine
• Intermittent or continual catheterization (inserting a thin tube through the urethra and into the bladder to remove urine)
Dietary Changes to Help Bladder Control Problems
Dietary changes you can try that may help to reduce urinary control problems include:
• Reduce the amount of fluids you drink if you drink more than 2 quarts (1.89 L) daily
• Reduce or eliminate caffeine-containing drinks, such as coffee, tea, and soda, from your diet
• Do not drink more than one alcoholic drink per day
Behavioral Changes for Bladder Control Problems
Behavioral treatments used to treat bladder control problems include:
Bladder training: Bladder training (also called bladder retraining) is used to treat motor urge incontinence (uncontrollable bladder contractions that force urine out of the bladder). Bladder training attempts to increase the time interval between urinating. A voiding schedule is established, and the person is trained to resist the first urge to urinate and refrain from urinating until the scheduled time. The interval between scheduled bathroom visits is increased until the person can refrain from urinating (remain continent) for several hours.
Timed voiding: Timed voiding (also called habit training) is used to treat functional incontinence. Functional incontinence occurs when something makes it hard for a person to reach or use a bathroom in time to urinate — such as a physical disability. In timed voiding, the person follows a schedule consisting of set times to urinate. The schedule is determined by the person’s own habits and does not attempt to increase the time between urinating or to teach the person to resist the urge to urinate.
Prompted voiding: Prompted voiding is also used to treat functional incontinence. It trains a caregiver to prompt the incontinent person to urinate. The intention is to decrease the chance of accidents by making the person aware of the need to urinate periodically. Prompted voiding is usually used in combination with timed voiding for people who are insufficiently aware of their bodily functions.
Kegel exercises: These exercises help strengthen the pelvic floor muscles, which play a role in bladder control. Your doctor can specify how to perform this exercise.
Absorbent products are items that absorb urine, such as mini-shields that attach to underwear or plastic-backed underpants. Most commercially available items are disposable (such as Depends or Attends), although some people with urinary incontinence may use absorbent cloths that can be washed and reused.
Absorbent products may be used to manage any form of incontinence.
Medications for Bladder Control Problems
For many types of bladder control problems, including motor urge incontinence, medications may be prescribed if behavioral methods do not work. Drugs are often used in combination with behavioral changes.
For motor urge incontinence (uncontrollable bladder contractions that force urine out of the bladder), the following medications may be used:
• Detrol LA
• Ditropan XL
• Gelnique Gel
• Oxytrol transdermal patch
Mechanical Aids for Bladder Control Problems
Mechanical aids may be used to treat bladder control problems associated with MS. These include:
• Catheters: A thin, flexible, hollow tube (catheter) can be inserted through the urethra (the tube through which urine leaves the body) into the bladder to drain urine.
Several different types of catheters are available.
• Urethral insert: A thin, flexible solid tube can be inserted into the urethra to block the flow of leaking urine.
• External urethral barrier: A self-adhesive patch can be placed over the opening from which urine leaves the body.
Surgery for Urinary Incontinence
Surgery or Botox may be used to treat some types of urinary incontinence, but it is used only as a last resort when other treatments have failed.
About our Co-Founder: With a bachelors in Social Work, Linda is 50 years old, happily married with eight children and 12 grandchildren. Diagnosed with MS in 1995 and now having accepted and truly embraced her new reality, Linda has created MSrelief.com. She is dedicated to proving that joy can be chosen while living with Multiple Sclerosis. Linda specializes in helping others, especially those with MS attain the lifestyle, independence and happiness amid living with MS.