MS is a condition that affects the central nervous system. The myelin sheath, a protective layer around nerves, becomes damaged, creating disruptions in the communication between your brain and your body.
What does this mean for your bladder?
Well, your bladder is essentially a muscular bag controlled by nerves. When MS disrupts these nerves, the bladder's ability to store and empty urine efficiently can be compromised. This can lead to symptoms such as urinary urgency, frequency, incontinence, and urinary tract infections.
Conversely, others might find it hard to fully empty their bladder, leading to urinary retention. Night-time issues can also be present, disturbing sleep patterns and affecting quality of life.
Recognising the Signs
Understanding and recognising the signs of bladder dysfunction can help you maintain control. Symptoms might include:
The need to urinate frequently
Waking up frequently at night to urinate
A sudden, intense urge to urinate, sometimes leading to involuntary leakage
Difficulty emptying the bladder fully
Painful urination or urinary tract infections
If you notice any of these changes, talk to your healthcare provider. They can help diagnose if bladder dysfunction is indeed the issue and can provide appropriate management options.
Tailored Tips and Strategies
Alright, now let's get to the crux of the matter: How do you manage this?
Medication and Therapies
Several medications and therapies have proven effective. Anticholinergic drugs can relax the bladder muscles, reducing urgency and frequency. For some people, Botox injections in the bladder muscle can help manage symptoms.
Don't shy away from physiotherapy either. Studies have shown pelvic floor muscle training to be effective in managing bladder symptoms in MS.
Fluid Management
One of the most common misconceptions is that reducing fluid intake will reduce urinary symptoms. But in reality, concentrated urine can irritate the bladder and actually increase symptoms, as well as heightening the risk of urinary tract infections.
Drink enough to keep your urine light in colour and reduce caffeine and alcohol intake as these can irritate the bladder.
Bladder Training
This involves developing a urination schedule, gradually increasing the interval between trips to the bathroom. A diary can help you track your progress. It might seem tedious, but it's a simple strategy that can lead to significant improvement.
Self-Catheterisation
If other strategies aren't successful, your doctor might suggest intermittent self-catheterisation. Although it might seem daunting at first, many find it a useful tool to regain control. Don't worry, training and support are available to help you get the hang of it. For extra security while self-catheterising, try Jude's Leak-proof pants as they can hold up to 8tsp of urine; just in case.
Exploring Alternative Therapies
More unconventional yet proven therapies also exist. For instance, neuromodulation, where electrical signals are used to alter nerve activity, has shown promise in managing bladder dysfunction. Acupuncture, too, has shown potential benefits.
Embracing Peer Support
Living with MS and bladder dysfunction is a journey, and it's okay to lean on others. Support groups, both online and in-person, can provide a space to share experiences, tips, and encouragement.
As we've seen, there's no one-size-fits-all solution, and you might need to experiment with different strategies to find what works for you.
