Changes in bladder function are a common symptom of multiple sclerosis (MS). As many as 80% of people with MS will experience some bladder dysfunction. In many cases, the issues can be treated so symptoms improve.
The Urinary Tract
When the urinary tract functions normally, your kidneys make urine, and it travels through your ureters into the bladder. When the bladder is full, you feel the urge to urinate. That urge comes after nerves in your bladder send signals up the spinal column to the brain, where you recognize the need to pee.
Once you begin to urinate, your brain sends a signal back down the spinal column telling your bladder to relax and your urinary sphincter to open. That lets the urine pass out of your body. If MS has damaged any of the nerves involved in this process, though, you may have difficulty with urination.
Urinary Retention
One issue MS can cause is urinary retention, where your bladder doesn't fully empty after you go to the bathroom. If this goes untreated, your bladder can become enlarged and lose muscle tone. As a result, you may experience symptoms, including:
- Urinary urgency
- Uncontrolled leaking of urine
- Difficulty starting to urinate
- Incontinence
You may also be at risk for a urinary tract infection (UTI). When urine stays in the bladder for too long, it can become a breeding ground for bacteria. If you have a UTI, you will need to treat it with antibiotics. You could also develop painful bladder stones that further irritate the urinary tract.
If you think your MS is causing problems with urine retention, speak to your doctor. They can do tests to see if you are emptying your bladder. Your doctor may use an ultrasound to look at your bladder immediately after you urinate. They may also insert a catheter to release any retained urine and measure the quantity.
Treating Urinary Retention
If you are retaining urine, your doctor may suggest intermittent self-catheterization (ISC). You will insert a small tube into your urethra several times a day to empty your bladder completely. Many people find that their bladder function returns to normal after several weeks of this. Your doctor may also suggest diet changes, including a cranberry supplement to prevent UTIs.
If your bladder issues persist, your doctor may do more tests to see if you have other problems with your urinary tract. You may need medication to manage symptoms such as overactive bladder. Your doctor will suggest the most appropriate medication if that becomes an issue.
