Table of ContentsView AllTable of ContentsCausesSigns and SymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Signs and Symptoms
Diagnosis
Treatment
Urinary incontinence is probably among the most distressing symptoms ofmultiple sclerosis(MS). Bladder dysfunction occurs in at least 80 percent of people living with MS, and up to 96 percent who have had the disease for more than 10 years will experience urinary complications as a result of their condition.
As frustrating and embarrassing as the symptoms may be, it’s important not to ignore them. There are many medical treatments available today that can improve urinary function, while simple dietary and lifestyle measures can help you better manage the condition, often with minimal stress or impact on your life.
Verywell / JR Bee
Dysfunction can occur for three reasons:
The bladder is spastic, making it less capable to hold urine.The urinary sphincter is spastic, preventing the bladder from emptying completely.The bladder is flaccid and unable to contract, leading to urine retention.
Urinary symptoms can present in one or more of the following four ways:
Complications
If bladder dysfunction is left untreated, it can cause permanent damage to the urinary tract.Urinary stones andurinary tract infections (UTIs)can often develop if the bladder is unable to empty. Chronic leakage can also lead to localized skin infections. In severe cases, potentially deadlyurosepsismay develop if a urinary infection spreads into the bloodstream.
It’s also important to note the impact of bladder dysfunction on a person’s peace of mind and lifestyle. It is not uncommon for people with bladder control problems to isolate themselves or restrict their daily routines, often adding to the burden ofdepressionfrequently seen in people with MS.
If positive, antibiotic treatment will be prescribed. If not, other tests (known as aurodynamicassessment) will be performed to evaluate how well the bladder and urethra are storing and releasing urine.
A urodynamic assessment takes around 30 minutes and involves the use of a small catheter to fill the bladder and record measurements.
As distressing as bladder dysfunction can be, urinary symptoms can usually be managed successfully with medications, lifestyle modifications, and other therapies.
For patients with spastic bladder:Bladder relaxants, such as Ditropan (oxybutynin), Detrol (tolterodine), Enablex (darefenasin), Toviaz (fesoterodine), Vesicare (solifenacin), Sanctura (trospium chloride), Myrbetriq (mirabegron), and Gemtesa (vibegron) are used.For patients with an overactive bladder sphincter:Alpha-adrenergic blocking agents, such asFlomax (tamsulosin), Uroxatral (alfuzolin), Cardura (doxazosin), and Rapaflo (silodosin), are used to promote the urine flow through the sphincter. In addition, antispastic drugs, such as Lioresal or Fleqsuvy (baclofen) and Zanaflex (tizanidine), can be used to relax the sphincter muscle.For patients with a flaccid bladder:Intermittent self-catheterization, wherein a thin tube is inserted into the bladder to better enable allow urination, may be recommended.
Other forms of treatment include behavioral therapies which teach people how to regulate fluid intake and strategically schedule urination while at home, work, or social engagements.
Dietary strategies include the restriction of caffeine, alcohol, and orange juice (the latter of which promotes bacterial growth) and the use of cranberry juice or tablets (which inhibit bacterial growth).
More severe cases may require surgical procedures, including an electrical implant, called anInterStim, which stimulates the sacral nerves and helps treat an overactive bladder.Botoxcan also be used to treat an overactive bladder.
A Word From Verywell
Having bladder problems can be upsetting, but the sooner you tell your healthcare provider, the sooner you will receive proper treatment and be able to resume your normal activities without worrying about leaks or frequent trips to the bathroom. Our Healthcare Provider Discussion Guide below can help you start a conversation with your practitioner about the specific symptoms you may be experiencing.
Multiple Sclerosis Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mahajan ST, Frasure HE, Marrie RA.The prevalence of urinary catheterization in women and men with multiple sclerosis.J Spinal Cord Med. 2013;36(6):632-637. doi:10.1179/2045772312Y.0000000084National Multiple Sclerosis Society.Bladder dysfunction in multiple sclerosis.National Institute of Neurological Disorders and Stroke.Multiple sclerosis.National Multiple Sclerosis Society.Urinary dysfunction and MS.National Institute of Diabetes and Digestive and Kidney Diseases.Definition and facts of urinary retention.National Institute of Diabetes and Digestive and Kidney Diseases.Urinary retention.National Kidney Foundation.Sepsis.National Multiple Sclerosis Society.Depression and multiple sclerosis.Lai HH, Shen B, Rawal A, Vetter J.The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population.BMC Urol. 2016;16(1):60. doi:10.1186/s12894-016-0179-xMilsom I, Wagg A, Oelke M, Chapple C.Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions.Int J Clin Pract. 2021;75(4):e13870. doi:10.1111/ijcp.13870Tornic J, Panicker JN.The management of lower urinary tract dysfunction in multiple sclerosis.Curr Neurol Neurosci Rep. 2018;18(8):54. doi:10.1007/s11910-018-0857-zDuque ALRF, Monteiro M, Adorno MAT, Sakamoto IK, Sivieri K.An exploratory study on the influence of orange juice on gut microbiota using a dynamic colonic model.Food Research International. 2016;84:160-169. doi:10.1016/j.foodres.2016.03.028Jensen HD, Struve C, Christensen SB, Krogfelt KA.Cranberry juice and combinations of its organic acids are effective against experimental urinary tract infection.Front Microbiol. 2017;8. doi:10.3389/fmicb.2017.00542National Institute on Aging.15 Tips to keep your bladder healthy.Orasanu B, Mahajan ST.The use of botulinum toxin for the treatment of overactive bladder syndrome.Indian J Urol. 2013;29(1):2-11. doi:10.4103/0970-1591.109975Additional ReadingWilliams, D.Management of bladder dysfunction in patients with multiple sclerosis.Nurs Stan.2012; 26(25):39-46. doi: 10.7748/ns2012.02.26.25.39.c8951
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mahajan ST, Frasure HE, Marrie RA.The prevalence of urinary catheterization in women and men with multiple sclerosis.J Spinal Cord Med. 2013;36(6):632-637. doi:10.1179/2045772312Y.0000000084National Multiple Sclerosis Society.Bladder dysfunction in multiple sclerosis.National Institute of Neurological Disorders and Stroke.Multiple sclerosis.National Multiple Sclerosis Society.Urinary dysfunction and MS.National Institute of Diabetes and Digestive and Kidney Diseases.Definition and facts of urinary retention.National Institute of Diabetes and Digestive and Kidney Diseases.Urinary retention.National Kidney Foundation.Sepsis.National Multiple Sclerosis Society.Depression and multiple sclerosis.Lai HH, Shen B, Rawal A, Vetter J.The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population.BMC Urol. 2016;16(1):60. doi:10.1186/s12894-016-0179-xMilsom I, Wagg A, Oelke M, Chapple C.Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions.Int J Clin Pract. 2021;75(4):e13870. doi:10.1111/ijcp.13870Tornic J, Panicker JN.The management of lower urinary tract dysfunction in multiple sclerosis.Curr Neurol Neurosci Rep. 2018;18(8):54. doi:10.1007/s11910-018-0857-zDuque ALRF, Monteiro M, Adorno MAT, Sakamoto IK, Sivieri K.An exploratory study on the influence of orange juice on gut microbiota using a dynamic colonic model.Food Research International. 2016;84:160-169. doi:10.1016/j.foodres.2016.03.028Jensen HD, Struve C, Christensen SB, Krogfelt KA.Cranberry juice and combinations of its organic acids are effective against experimental urinary tract infection.Front Microbiol. 2017;8. doi:10.3389/fmicb.2017.00542National Institute on Aging.15 Tips to keep your bladder healthy.Orasanu B, Mahajan ST.The use of botulinum toxin for the treatment of overactive bladder syndrome.Indian J Urol. 2013;29(1):2-11. doi:10.4103/0970-1591.109975Additional ReadingWilliams, D.Management of bladder dysfunction in patients with multiple sclerosis.Nurs Stan.2012; 26(25):39-46. doi: 10.7748/ns2012.02.26.25.39.c8951
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mahajan ST, Frasure HE, Marrie RA.The prevalence of urinary catheterization in women and men with multiple sclerosis.J Spinal Cord Med. 2013;36(6):632-637. doi:10.1179/2045772312Y.0000000084National Multiple Sclerosis Society.Bladder dysfunction in multiple sclerosis.National Institute of Neurological Disorders and Stroke.Multiple sclerosis.National Multiple Sclerosis Society.Urinary dysfunction and MS.National Institute of Diabetes and Digestive and Kidney Diseases.Definition and facts of urinary retention.National Institute of Diabetes and Digestive and Kidney Diseases.Urinary retention.National Kidney Foundation.Sepsis.National Multiple Sclerosis Society.Depression and multiple sclerosis.Lai HH, Shen B, Rawal A, Vetter J.The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population.BMC Urol. 2016;16(1):60. doi:10.1186/s12894-016-0179-xMilsom I, Wagg A, Oelke M, Chapple C.Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions.Int J Clin Pract. 2021;75(4):e13870. doi:10.1111/ijcp.13870Tornic J, Panicker JN.The management of lower urinary tract dysfunction in multiple sclerosis.Curr Neurol Neurosci Rep. 2018;18(8):54. doi:10.1007/s11910-018-0857-zDuque ALRF, Monteiro M, Adorno MAT, Sakamoto IK, Sivieri K.An exploratory study on the influence of orange juice on gut microbiota using a dynamic colonic model.Food Research International. 2016;84:160-169. doi:10.1016/j.foodres.2016.03.028Jensen HD, Struve C, Christensen SB, Krogfelt KA.Cranberry juice and combinations of its organic acids are effective against experimental urinary tract infection.Front Microbiol. 2017;8. doi:10.3389/fmicb.2017.00542National Institute on Aging.15 Tips to keep your bladder healthy.Orasanu B, Mahajan ST.The use of botulinum toxin for the treatment of overactive bladder syndrome.Indian J Urol. 2013;29(1):2-11. doi:10.4103/0970-1591.109975
Mahajan ST, Frasure HE, Marrie RA.The prevalence of urinary catheterization in women and men with multiple sclerosis.J Spinal Cord Med. 2013;36(6):632-637. doi:10.1179/2045772312Y.0000000084
National Multiple Sclerosis Society.Bladder dysfunction in multiple sclerosis.
National Institute of Neurological Disorders and Stroke.Multiple sclerosis.
National Multiple Sclerosis Society.Urinary dysfunction and MS.
National Institute of Diabetes and Digestive and Kidney Diseases.Definition and facts of urinary retention.
National Institute of Diabetes and Digestive and Kidney Diseases.Urinary retention.
National Kidney Foundation.Sepsis.
National Multiple Sclerosis Society.Depression and multiple sclerosis.
Lai HH, Shen B, Rawal A, Vetter J.The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population.BMC Urol. 2016;16(1):60. doi:10.1186/s12894-016-0179-x
Milsom I, Wagg A, Oelke M, Chapple C.Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions.Int J Clin Pract. 2021;75(4):e13870. doi:10.1111/ijcp.13870
Tornic J, Panicker JN.The management of lower urinary tract dysfunction in multiple sclerosis.Curr Neurol Neurosci Rep. 2018;18(8):54. doi:10.1007/s11910-018-0857-z
Duque ALRF, Monteiro M, Adorno MAT, Sakamoto IK, Sivieri K.An exploratory study on the influence of orange juice on gut microbiota using a dynamic colonic model.Food Research International. 2016;84:160-169. doi:10.1016/j.foodres.2016.03.028
Jensen HD, Struve C, Christensen SB, Krogfelt KA.Cranberry juice and combinations of its organic acids are effective against experimental urinary tract infection.Front Microbiol. 2017;8. doi:10.3389/fmicb.2017.00542
National Institute on Aging.15 Tips to keep your bladder healthy.
Orasanu B, Mahajan ST.The use of botulinum toxin for the treatment of overactive bladder syndrome.Indian J Urol. 2013;29(1):2-11. doi:10.4103/0970-1591.109975
Williams, D.Management of bladder dysfunction in patients with multiple sclerosis.Nurs Stan.2012; 26(25):39-46. doi: 10.7748/ns2012.02.26.25.39.c8951
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