Multiple Sclerosis and Bladder Control Problems

Bladder control problems occur in at least 80% of people with multiple sclerosis. Because MS interrupts or slows the transmission of signals to and from the brain, the electrical impulses to the muscles that are involved in emptying the bladder can become disrupted.

These problems can seem overwhelming and often embarrassing. But, there are steps you can take to manage bladder control problems.

Types of Bladder Control Problems With Multiple Sclerosis?

Those with multiple sclerosis can experience the following bladder control issues:

• Urinary urgency. People with this problem feel the need to urinate frequently and urgently. The small "tickle" and feeling of pressure that help us recognize the right time to head to the restroom is very intense. When urinary urgency takes place, the signals that coordinate urination are disrupted and you experience this uncontrollable urge to urinate which can cause incontinence.
• Incontinence. This is the loss of bladder control. Sometimes MS will disrupt the nerve signals sent to the body parts that control urine movement allowing urine to come out involuntarily.
• 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.

What Happens if a Bladder Control Problem Goes Untreated?

If left untreated, bladder control problems can cause other health concerns, including:

• Repeated urinary and bladder infections or kidney damage
• Personal hygiene problems
• Interfering with normal activity and leading to isolation

How Are Urinary Control Problems Treated in Multiple Sclerosis?

For those with multiple sclerosis, treatment of urinary control problems is individualized. Many times a doctor who specializes in treating incontinence, called a urologist, will be involved in your care. Your doctor may recommend one or more of the following:

• Dietary changes to minimize incontinence
• Behavioral changes
• Medications
• Mechanical aids to help control the flow of urine
• Intermittent or continual catheterization (inserting a thin tube through the urethra and into the bladder to remove urine)

Medications for Bladder Control Problems

For many types of bladder control problems, including motor urge incontinence, medications may be prescribed if behavioral methods do not work. Drugs are often used in combination with behavioral changes.

For motor urge incontinence (uncontrollable bladder contractions that force urine out of the bladder), the following medications may be used:

• Detrol
• Detrol LA
• Ditropan
• Ditropan XL
• Enablex
• Gelnique Gel
• Oxytrol transdermal patch
• Sanctura
• Tofranil
• Toviaz
• Vesicare