Bladder issues when you have MS

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, including the brain and spinal cord. Because of its impact on nerve signals, you might find you experience a range of bladder problems, which are often referred to as neurogenic bladder dysfunction.

These bladder problems can vary in severity and can significantly affect your quality of life. Some common bladder problems that people with MS may experience include

1. Urinary urgency and frequency. Many people with MS may feel a frequent and urgent need to urinate. This can lead to increased trips to the bathroom and disruptions in daily activities.
2. Urinary incontinence. MS can disrupt the signals between the brain and the bladder, leading to involuntary leakage of urine. This can happen during physical activities, when coughing or sneezing, or even spontaneously.
3. Urinary retention. Some people with MS may have difficulty fully emptying their bladder. This can lead to a feeling of incomplete voiding, which in turn can increase the risk of urinary tract infections.
4. Nocturia. Nocturia refers to the need to wake up during the night to urinate. MS can disrupt the normal sleep pattern by causing increased urine production during night-time hours.
5. Hesitancy. Difficulty initiating the urinary stream is another common issue. This can be frustrating and time-consuming.
6. Straining. Straining to initiate or maintain the urinary stream can occur due to MS-related nerve damage affecting the muscles involved in bladder control.
7. Dysfunctional voiding patterns. Some individuals with MS may have irregular patterns of voiding, which can further complicate bladder management.
8. Bladder spasms. Neurogenic bladder dysfunction can lead to involuntary contractions of the bladder muscles, causing spasms and discomfort.
9. Mixed incontinence. This refers to a combination of stress incontinence (leakage with physical activity) and urge incontinence (sudden strong urge to urinate).
10. 1. Overflow incontinence. In cases of severe urinary retention, the bladder may become overfull and leak small amounts of urine.

    Managing these bladder problems often requires a multidisciplinary approach involving neurologists, urologists, physical therapists, and other healthcare professionals. Treatment options can include

    • Bladder training. This involves scheduling regular bathroom breaks to gradually increase bladder capacity and control.
    • Medications. Certain medications can help relax the bladder muscles and reduce urgency and frequency.
    • Catheterisation. Intermittent self-catheterisation or using an indwelling catheter may be necessary to empty the bladder fully.
    • Physical therapy. Pelvic floor exercises and techniques can help improve bladder control and reduce incontinence.
    • Lifestyle modifications. Managing fluid intake, avoiding bladder irritants (such as caffeine and alcohol), and maintaining a healthy weight can help alleviate symptoms.
    • Surgical interventions. In severe cases, surgical options like bladder augmentation or sling procedures may be considered.

    It’s important to work closely with your healthcare team to develop a personalised treatment plan that addresses specific bladder issues to improve your overall quality of life.

    At MS-UK, we produce a Bladder and Bowel Choices booklet which is packed with information about bladder and bowel problems that can be caused by MS. It covers options for treatment and management, including catheters, drug treatments, plus lifestyle tips. There is also advice from other people living with MS and bladder and bowel problems. You can download it free at ms-uk.org/bladder-and-bowel-choices-leaflet