Sclerosis: MS-Related Bladder Control Problems
the problems that occurs in people who have MS is loss of bladder
control—wetting the pants or the bed. The cause of this is a breakdown in the
transmission of signals between the brain and the bladder.
Yes. Embarrassing? Yes. Inevitable? No! Though this problem is all too common
among MS patients (roughly 80% of MS patients have it), the good news is that
there are ways to control it.
Most Common Types of Bladder Control Problems
take a look at the most common types of bladder-control issues that MS patients
are faced with:
We all know the feeling that tells us, “I’d better go and pee now.” People with
urinary urgency experience that feeling often and feel it strongly. What’s
more, urinary urgency not only causes the sensation of needing to urinate
but also may cause urination to begin before the person can get to the
- Incontinence. Incontinence
is the loss of bladder control—wetting the pants or the bed. This may
occur with or without your first feeling the need to urinate. The brain
and the bladder “talk to each other” by way of nerve signals, but MS can
create an interruption in the flow of those signals, somewhat like jamming
a radio frequency. The result is that the signals don’t travel back and
forth the way they should, and as a consequence, the MS patient may find
herself or himself emptying his/her bladder partially or totally.
- Nocturia. Nocturia is
the medical term for the need to get up often during the night to urinate.
This is inconvenient, annoying, and sleep-disruptive. Nocturia has various
causes, but in people with MS, it’s once again a question of an
interruption in the communication between the brain and the bladder. The
result? That annoying experience of waking up with an urgent need to head
to the bathroom.
After our discussing urgency, incontinence, and nocturia, you may think
that all MS problems related to the bladder involve the need to empty it
at inopportune times. But actually urinary hesitancy is at the other end
of the spectrum. Though not as inconvenient or embarrassing, this
condition, too, can be pesky at the least. The name “urinary hesitancy”
refers to difficulty getting your urine flow started when you sit down on
the toilet (or, for men, stand at the ready). Once again, the problem
results from a breakdown in the body’s signals between the brain and the
What Happens if a Bladder Control Problem Goes Untreated?
bladder control problems we’ve been discussing are, as we said, embarrassing
and uncomfortable to begin with, but there’s even more to it than that. If you
don’t do anything to help the situation, they can lead to even more problems.
- Repeated urinary and bladder
infections, or kidney damage
- Personal hygiene problems, such
as unpleasant odor
- A self-imposed restriction on
your activities (e.g. refusal to leave the house) and an unwillingness to
be around others
How Can You Deal with Urinary Control Problems?
good news? There are ways that these types of urinary problems can be minimized
or eliminated. There is a menu of different choices in treatment, one or more
of which can help. The choice(s) will vary from person to person, often under
the guidance of a doctor who specializes in bladder-related issues. Here are some of the types of treatment your
doctor may recommend:
- Changes in your diet
- Changes in your behavior
- Mechanical aids to help control
the flow of urine
- Catheterization (inserting a
thin tube through the urethra and into the bladder to remove urine). The
catheter may be left in place, or inserted only at times.
take a closer look at what’s involved in each of these types of treatment.
increase your urinary control through your diet may include any or all of the
- Drinking less fluids. It stands
to reason that if you drink less, you will have less need to urinate. But
reducing your intake of fluids is a good idea only if you drink more than
2 quarts (1.89 L) of liquids a day.
- Stopping drinking anything that
contains caffeine, or at least drinking less of caffeinated drinks. These
include coffee, tea, and some sodas. Caffeine increases the need to
- Not having more than one
alcoholic drink a day.
most common behavioral change is something called bladder training, also known
as bladder retraining. This method is used to cope with what’s called “motor
urge incontinence,” a term that refers to contractions of the bladder that you
can’t control, which result in urine being squeezed out of your bladder.
bladder training, your doctor will give you a schedule of when you are to
urinate, and you are asked to stick to the schedule as much as possible. If you
feel the need to urinate in between scheduled “pee breaks,” you’re asked to try
to resist the urge and not use the bathroom till your next scheduled break. As
you become successful, the length of time between scheduled trips to the
bathroom is increased. By the successful end of your training, you should be
able to avoid the bathroom and still stay dry for several hours.