March is Multiple Sclerosis (MS) Awareness Month. Unfortunately, MS is no stranger to the bladder world. Science has helped us understand that MS patients have an altered, protective coating around nerve fibers; unfortunately, the nerves surrounding the bladder are not exempt. As a result, the signals between the brain and bladder are delayed and symptoms of urinary urgency, frequency, incomplete emptying, urine loss, and/or nighttime voiding often emerge.
- Will 80% of individuals with MS have urinary symptoms? Yes.
- Do nearly 50% of individuals WITHOUT MS have urinary symptoms? Yes.
- Can you have urinary symptoms that are unrelated to MS? Yes.
- If you have MS, should you be offered the same options of continence treatments as someone without MS? Yes.
Let’s be clear: bladder problems do not discriminate. Many people suffer from bladder related symptoms, with and without MS. Regardless of the cause, improving overall function remains the goal. If a clinician dismisses your bladder related concerns “because you have MS”, then it might be time to look for another clinician that has a better perspective.
Meanwhile, try not to become discouraged. Remind yourself that MS doesn’t get to take all of the bladder blame. Regardless of who we are, an array of reasons for bladder problems may emerge: bladders change with aging; blood vessels and nerves deteriorate with diabetes; dopamine becomes deficient with Parkinson’s; medication side effects present with hypertension; and pelvic radiation transforms tissue with cancer. This list goes on and on.
For patients with MS, although a bit more challenging, the goal for improving bladder function remains the same. There are treatments, covered by insurance, that can be tailored to you and improve your bladder symptoms:
- Dietary modifications (believe it or not, there are some tasty alternatives)
- Pelvic floor muscle exercises (which 70% of us do incorrectly)
- Bladder retraining (without going to the gym)
- Pharmaceutical options (prescriptive and over-the-counter)
- Posterior tibial nerve stimulation (an in-office procedure where you keep your pants on!)
- Sacral nerve modulation (aka pacemaker for the bladder which has been available for nearly 20 years in the States)
- Botox for the bladder (an in-office procedure that unfortunately will not make our faces look any younger)
- And a wide range of catheter options (easier than it sounds)
Regardless of health status, bladder problems make a strong presence around the world. For many (with and without MS), the goal will not be to cure bladder complaints; rather, make the symptoms more manageable. Sometimes it takes a little bit of work to find the right clinician that will support you along the way. https://www.nafc.org/find-a-doctor Your efforts will be worth it.
MS Symptoms. (n.d.). National MS Society. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms
NAFC Doctor Finder. (2020). National Association for Continence. https://www.nafc.org/find-a-doctor