MS Bladder Symptoms

People with multiple sclerosis, or MS, often find it easier to talk about the feelings they experience in their limbs, or even their inability to move appendages the way they used to, than to discuss MS's effects on internal organs such as the bladder. Though it is a sensitive subject, there is no reason that information about MS's effect on the bladder should be ignored. A little information can go a long way toward your understanding of the disease and make it easier to discuss unpleasant symptoms with your doctor and family.

Mechanics

• MS is a chronic disease caused by the immune system's attacking the nerve pathways of the body. Nerves are essentially conductors of electrical impulses, impulses whose integrity is protected by a protein insulating sheath called myelin. As the rubber around an electrical cord prevents shorts in electronic appliances, myelin prevents messages from shorting out when traveling along the neural pathways. MS degrades those myelin sheaths, making control of the bladder difficult.

Types of Dysfunction

• There are two types of bladder dysfunction involved with MS: inability to urinate and leakage of urine.

  The flow of urine is controlled by a sphincter in the bladder; basically a door consisting of a muscle which relaxes to open and contracts to close. An inability to urinate means that, even though a person senses that his bladder is full, the neural impulse telling the muscle to open is interrupted and never reaches the urinary sphincter, and the "door" remains closed.

  Leakage of urine is the opposite of inability to open the urinary sphincter; in some cases, the sphincter remains at least partially open, resulting in involuntary leaks.

Manifestations

• Bladder dysfunction can manifest in four basic ways: a hesitancy to urinate, a sudden urgency to urinate, frequent need to urinate, and "incontinence," or inability to delay urination after the initial feeling of a need to urinate. All four manifestations can lead to urinary tract infection (UTI), which exacerbates MS's bladder symptoms.

Medical treatment

• Often medications are prescribed, such as antispasmodics to control problems with the sphincter opening, drugs that encourage a greater flow of urine, or drugs that reduce the flow of urine.

  In some cases, catheterization (insertion of a small, flexible tube into the urinary tract) is an option. In some extreme cases, a surgical procedure may be performed to implant an electrical device on the nerves in the small of your back to regulate the impulses sent to the bladder

Behavior treatment

• Mostly, bladder dysfunctions can be controlled through changes in your behavior. For example, reducing stimulants such as caffeine can help reduce instances of bladder dysfunction. Also, training yourself to urinate on a regular schedule as well as regulating the amount of fluid taken in can help alleviate many MS bladder symptoms.