Multiple Sclerosis (MS), an autoimmune disease that affects the central nervous system, affects over 1 million people over the age of 18. When someone has MS, their immune system attacks the protective coating that covers the nerves, called myelin. As a result, signals from the brain are interrupted. This can cause many problems ranging from balance, vision, numbness or tingling, fatigue, blindness, or even paralysis. Many people with MS (approximately 80%) also experience bladder problems.
In patients with MS, lesions interrupt the nerve signals that control the bladder and urethra. This can lead to an overactive bladder or spastic bladder, which causes them to have an urgent and frequent need to use the bathroom. When they are unable to make it to the bathroom in time, this can result in an accident and is called Urge Incontinence. It may also lead to an underactive bladder, in which the bladder retains urine and makes it difficult to completely empty your bladder.
Treating bladder conditions urgently is extremely important in patients with MS, as prolonging treatment can lead to worsening MS symptoms, kidney or UTI infections. Suffering from bladder leaks can also take an emotional toll. Many people are scared to go out for fear of having an accident. It can affect their relationships with friends and family, can impact their work, and can have a very negative effect on their overall quality of life.
HOW TO STOP BLADDER LEAKS CAUSED BY MS
If you have MS and are experiencing bladder leaks, talk to your doctor right away. He or she can assess your symptoms, refer you to a specialist, and determine the best course of action for treating your bladder leaks. The good news is that bladder leaks can often be effectively treated with lifestyle changes, medications, physical therapy, or other simple procedures. Below are some of the most common forms of treatment:
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ADJUST YOUR DIET.
Did you know that what you eat can have a big effect on how your bladder behaves? Certain foods and drinks can aggravate your bladder and may trigger the urge to go. Take note of these common bladder irritants and keep a bladder diary to see if you notice any patterns (like always having to use the bathroom after your morning coffee.)
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FLUID MANAGEMENT.
You should never limit your fluids, but you can time them to avoid having an accident. For instance, limiting the amount of water you drink a few hours before bedtime may help to reduce the need to get up in the night to use the bathroom. And try to limit drinks that are known bladder irritants, as stated above. Choose water over things like coffee, sodas, or alcohol.
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BLADDER TRAINING.
Your bladder is a muscle and just like any muscle, it can be trained. Try to “hold it” for small periods of time, increasing the length of time each time you feel the urge to go. You can also time your voids, increasing the length of time between voids slowly until they’re at a manageable distance apart. This process can take time but can be very effective.
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PELVIC FLOOR PHYSICAL THERAPY.
Many people find great success at managing bladder leaks with pelvic floor physical therapy. A trained PT can help identify areas where your pelvic floor may be too weak or too tense and can put you on an exercise plan to address those issues. They can also help ensure you’re doing your exercises (including Kegels, if needed) correctly.
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MEDICATIONS.
There are many medications available to treat bladder leaks. Talk to your doctor to determine if one of these may be a good option for you.
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BOTOX.
You may think of Botox as something to fight wrinkles, but Botox can be used to treat bladder leaks too! Injected into the bladder, Botox helps to relax the muscle and block the nerve signals that trigger OAB. A Botox injection is needed about every 6 months to effectively treat an Overactive Bladder. Click here to learn how one woman with MS used Botox to treat her bladder leaks.
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PERCUTANEOUS TIBIAL NEUROMODULATION (PTNM).
PTNM stimulates the tibial nerve through an acupuncture-like needle placed in the skin near your ankle. PTNM is thought to normalize control of the bladder’s natural reflexes by gently stimulating the tibial nerve. Your doctor can administer PTNM in his or her office.
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SACRAL NEURAL MODULATION (SNM).
Similar to PTNM, SNM stimulates the sacral nerve, which delivers signals between the brain and the bladder. A neurostimulator is implanted parallel to the sacral nerve. This neurostimulator generates mild electrical pulses, which stimulate the sacral nerve and normalize the communication between the bladder and the brain, helping to control symptoms of overactive bladder. Your doctor can perform this procedure in his or her office, and typically a trial period is used to determine if SNM is right for you.
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INTERMITTENT SELF CATHETERIZATION.
In patients who have difficulty emptying their bladder, an intermittent self catheter may be recommended. This is where a small tube is inserted into the urethra, allowing the bladder to empty. Done once or twice per day, this can help prevent the bladder from becoming too full and prevent feelings of urgency or frequency, and accidental leaks
