MULTIPLE SCLEROSIS and incontinence
Multiple Sclerosis can be a frustrating and exasperating condition for those dealing with the disease. When the brain and body have difficulty communicating, this causes control issues for many bodily functions, including urination and voiding. Because emptying the bladder requires a coordination between bladder muscles and the sphincter, any disruption in the signals can create problems that are overwhelming and often embarrassing. Good news is, there are steps you can take to manage bladder control problems.
It helps to identify what kind of incontinence you might be dealing with in order to take the right steps towards limiting the effects it has on your daily life.
- Urinary Urgency - People with this problem feel the need to urinate frequently and urgently. That familiar "tickle" and pressure that help us recognize the right time to head to the restroom is unusually intense. When urinary urgency takes place, the signals that synchronize urination are disrupted which creates an uncontrollable urge to urinate—the very definition of incontinence.
- 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.
- Sphincter Dyssynergia - Another common problem seen in a bladder affected by MS is sphincter dyssynergia (SD). This occurs when there is both a storage dysfunction and an emptying dysfunction. The bladder is trying to contract and empty, and the urethra is contracting instead of relaxing, therefore allowing little or no urine to pass. This phenomenon is usually due to nerve damage in the spine as opposed to the brain.
- Underactive Bladder - The nerve damage occurring from MS can cause the bladder to weaken, and as a result, the bladder may not contract to release the urine. If nerve signals from the bladder cannot tell the brain to empty, the bladder continues to fill and expand. Eventually, it overflows, with leakage of urine (i.e., overflow incontinence). Even if urination occurs, the bladder usually does not empty completely, resulting in urinary retention.
If left untreated, bladder control problems can cause other health concerns, including:
- Repeated urinary and bladder infections or kidney damage
- Personal hygiene problems
- Interference with normal activity, leading to isolation
For those with MS, it’s not just a matter of trying harder. Because the disease affects different nerves within the body, many treatments may need to be tried before finding success. The key is to have positive support from your physician and loved ones so you can concentrate on making each day better than the last. Treatment of urinary control problems is individualized. Your physician may refer you to an urologist who specializes in treating incontinence. Treatment may consist of one or a combination of the following techniques.
- 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, or soda, from your diet
- Do not drink more than one alcoholic drink per day
- Bladder training - Also called bladder retraining, is used to increase the time interval between urinating. The interval between scheduled bathroom visits is increased until the person can refrain from urinating (remain continent) for several hours.
- Intermittent Catheterization - Catheterization involves inserting a tube through the urethra and into the bladder to drain urine. This practice can prevent the bladder from overfilling, eliminate residual urine, and help prevent urinary infections. Catheter design and materials have come a long way and a patient’s comfort has been improved significantly.
The FDA has approved OXYTROL FOR WOMEN (oxybutynin transdermal system, 3.9 mg/day) as the first-ever, over-the-counter treatment available to treat overactive bladder in women. It is currently available in pharmacies and big box retailers for purchase. OXYTROL FOR WOMEN is a thin, flexible, and clear patch that is applied to the abdomen, hip, or buttock every 4 days for the relief of overactive bladder. However, for men, OXYTROL is available by prescription only.
Hear Amy's Story
Want to hear first hand how one person dealt with incontinence difficulties as a result of MS? Listen to Amy's story and hear how she bravely faced down incontinence.