Then, it happened. I didn’t notice it at first, it can be sneaky like that. But then I felt it, the warmth and urgency that I have felt so many times before.
Bladder Dysfunction in MS
Bladder dysfunction is one of the most commonly reported symptoms from MS patients, with up to 80% being affected. If an individuals system is working properly, urine will collect slowly in the bladder and cause it to expand. When enough fluid has accumulated nerves in the bladder will send signals to the spinal cord which will send signals to the brain that the bladder needs to be emptied. When the person is in the bathroom, the brain sends signals to the spinal cord which triggers the bladder and sphincter to open.
Dysfunction occurs when lesions are present and inhibit nerve signals from reaching their intended destination. With so many signals being sent in between the brain and the spinal cord multiple times, it’s no wonder bladder dysfunction is such a common problem! The specific dysfunction can happen for two reasons, the bladders spastic or the bladder isn’t emptying all the way because the sphincter is spastic.
Because of either cause, there can be many symptoms present including:
If bladder dysfunction continues without treatment, it can lead to severe symptoms and can lead to permanent damage to the urinary tract. This occurs when urine is left in the bladder and can lead to urinary tract infections, bladder infections, kidney infections or stones. Also. these issues can also lead to emotional distress and avoidance of social situations or isolation.
Thankfully, there are many ways to treat bladder dysfunction with either lifestyle modifications, medications or procedures. Lifestyle modifications include both dietary and behavioral changes. Dietary changes include liming caffeine and alcohol (as these can be irritating to the bladder) as well as limiting fluids several hours before bed time if you struggle with waking up in the middle of the night.
Behavioral interventions include timing fluid intake as well as urinating on a regular schedule to help train the bladder. Other interventions include:
There are many medications available to help control spasticity and to promote the flow of urine. Some include baclofen, oxybutynin and terazosin. If symptoms persist after these interventions are tried, there are surgical options available as well.
Dealing with bladder issues during day to day life can be tiring and isolating, but there are ways to plan ahead.
I always tell my husband, if I could make one symptom magically disappear, this would be it. But I’ve found that through lifestyle changes and paying attention to my body, I am more able to manage my bladder dysfunction. I know that around my cycle, when I am dehydrated and when I drink coffee, my bladder symptoms act up. So being extra prepared on some days, really helps me both mentally and practically.
Bladder dysfunction is no joke, and can cause a boat load of other issues if left untreated. But thankfully there are many ways we can manage the symptoms and not let it run and ruin our lives.
My panic quickly grew to terror. ‘This has never happened in public before, what do I do?’ I thought to myself. I didn’t feel like I could run away from all of my things to the bathroom, I felt trapped. I rushed through the transaction as fast as I could in a socially acceptable way, and then ran to the bathroom. The damage was done and I began to cry. I gave myself a few more moments of pity before running from the bathroom to my awaiting husband and car. He could tell by my speed and tears that something had happened. Immediately he began asking what was wrong, “Just drive” was all I could muster. Eventually I was able to calm down to gesture toward my pants and said
“yeah, that just happened”.