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It is fairly common for people who have MS to have some difficulty with bladder control. Impaired bladder function affects up to 90% of people with MS at some time during the course of their illness. Urinary symptoms are disruptive and may cause medical, emotional and hygienic problems that can interfere with critical life areas such as social, vocational and sexual activities. Most bladder symptioms can be successfully managed and urinary complications prevented.
Bladder problems in MS are due to the spinal cord involvement which occurs in the disease. Symptoms vary and include the following:
- Urgency -- the need to reach the toilet quickly
- Frequency -- urination more than five to six times a day
- Hesitancy -- difficuly in initiating urination
- Nocturia -- awakening at night because of the need to urinate
- Incontinence -- leakage of urine or loss of urinary control
- Retention -- bladder does not empty completely at each voiding
You may have to see your doctor on more than one occasion to sort out your bladder problem, and a specialist in urological disorders may have to be consulted. If you find that you are needing to urinate frequently, or if you are having difficulty passing urine, you should see your doctor without delay.
Medications are available that can slow down an overly irritable bladder, and others can help activate the bladder when its emptying seems sluggish. Many people have minimal inconvenience once they seek help. Keep your doctor up to date about your urinary habits and any related problems.
Some people may develop urinary tract infections, usually characterised by frequent urination, strong smell and discolouration of the urine, and sometimes abdominal or back pains and fever. The presence of MS makes it more difficult for your urinary system to "get by" without specific medication, so don't try to treat yourself. There are also methods of emptying the bladder of as much residual urine as possible - often the cause of infection. Your doctor or another rehabilitation team member may instruct you in this depending upon your particular problem.
A number of practical steps can be taken as well. If you do have problems with frequent urination or lack of control, when you go out you should be aware of the location of toilets in public places such as theatres, restaurants and stores. Remember, if you are always hunting for the toilet, you probably need to see your doctor about help in getting into good bladder habits.
Part of the problem may be solved by timing fluid intake. When some people encounter bladder frequency or lack of control, they drink hardly anything. This approach is not recommended and can have serious repercussions. The kidneys require about two litres of fluid a day to do their work in eliminating waste products efficiently.
The answer is to plan fluid intake. Don't drink great volumes of fluid just before going out or going to bed. On the other hand, that same total amount of fluid might easily be handled spread over a longer period of time. There is no substitute for common sense.
Appropriate clothing, padding and devices for incontinence are available at reasonable cost and can be invaluable in coping with lack of control. These are available at chemists or medical supply companies. Shop around and compare prices since costs can vary greatly from place to place.
Every symptom you get is not necessarily related to MS: men may develop prostate trouble and women vaginal infections. It is best to let your doctor sort out the cause and recommend treatment. Urinary problems in MS are common and can be embarrassing and socially disruptive. However, they respond well to treatment and can be controlled to the extent that normal activities can be resumed.
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