This article is evidence-based, verified by Dr. Ahmed Zayed.
People with multiple sclerosis often experience problems with their urinary tract. These issues can be concerning and even embarrassing for the person.
Even though urinary incontinence can be problematic among people with multiple sclerosis, there are ways to treat these complications effectively. These range from managing the intake of fluids to strategies that help with bladder retraining. There are medications and therapies that can also help.
Continue reading if you want to learn how you can help manage urinary incontinence in a loved one who suffers from multiple sclerosis.
Multiple Sclerosis And Incontinence
Multiple sclerosis causes damage to nerves. The bladder and entire urinary system rely on healthy nerves to function in a normal way. When there is a problem with the bladder’s nerves, a person is at risk of experiencing urinary incontinence.
In one study, 403 multiple sclerosis patients were analyzed. The goal was to determine the effect of multiple sclerosis on the urinary tract. Among the patients, a total of 35% reported symptoms associated with urinary incontinence. Female patients seemed to be at a higher risk of urinary incontinence in the presence of multiple sclerosis.
Treatment is possible and can help a person effectively manage the urinary incontinence symptoms. The person should first note what type of incontinence they experience.
- Urge incontinence refers to damage to nerves n the brain that are responsible for controlling the bladder. There will be a need to urinate frequently. This is because the person’s bladder is likely to become overactive if they experience urge incontinence.
- Stress incontinence is when urine tends to leak from the urethra when the person performs certain actions. These actions generally include sneezing and laughing. There may also be a leak of urine when coughing. In these cases, the pelvic floor muscles have weakened due to multiple sclerosis.
It is possible for a person to have both urge incontinence and stress incontinence.
Steps To Treating Incontinence In Multiple Sclerosis Patients
The first step is to define the type of incontinence the person suffers from – and to determine if both types may be present. The risk of kidney damage should be assessed too. This helps to understand whether there is a risk of two major MS complications – skin breakdown and urosepsis.
Factors That Affect Treatment And Management
A tailored treatment plan is generally needed to help a person manage urinary incontinence. The progression of multiple sclerosis will play a major role in helping to understand how serious the complication is. This analysis also helps a person identify the level of care that may be needed to manage the urinary incontinence symptoms.
Some factors that are usually considered include:
- Whether MS has affected the person’s cognitive function
- Current dexterity of the individual
- Whether support is available at the person’s home
- Whether the person suffers any problems with their mobility
Lifestyle Changes For Managing Urinary Incontinence
Managing urinary incontinence in a person with multiple sclerosis start with a few lifestyle changes in many cases.
Fluid intake needs to be monitored. More fluids mean more urination – and this can increase the effects that the complication has on the person. There are many cases where a decrease in fluid intake may yield effective results.
When controlling fluid intake, a person should consider all liquids that are being consumed – not just water. Coffee is an excellent example – a reduction in coffee may help improve symptoms. The caffeine in coffee may also act as a diuretic, which may make urinary incontinence worse.
Pelvic Floor Exercises For Urinary Incontinence
Stress incontinence is caused by a weak pelvic floor muscle. This is a result of nerve-related damage and a reduction in chemical messages between nerves – caused by multiple sclerosis. The use of pelvic floor exercises in people with stress incontinence can be a useful strategy.
Pelvic floor exercises are simple to perform. There are studies that have confirmed the efficacy of pelvic floor exercises in the management of urinary incontinence.
It is generally easy to learn how to do these exercises. No special equipment is needed, and they can be performed anywhere and at any time.
Medications
There are certain pharmaceutical drugs that may also help in the management of urinary incontinence. It is important that a healthcare provider prescribe these drugs to the person. This ensures the drug will not interfere with any medication the person is taking for multiple sclerosis.
Medications are most effective for people who experience urge incontinence. There are pharmaceutical drugs that can effectively reduce the frequency of urges to urinate the patient experience. These drugs will also help to reduce spasms.
Percutaneous Tibial Nerve Stimulation
Another strategy that may assist with incontinence in a person with multiple sclerosis is percutaneous tibial nerve stimulation, also known as PTNS. During this therapy, a needle electrode is used. The procedure is considered safe. The needle electrode will transmit impulses that signal certain parts of the person’s body.
In the case of incontinence, percutaneous tibial nerve stimulation will generally be used to submit signals to two specific parts. These include the pelvic floor, as well as the bladder.
This is considered an alternative therapy and may not be supported by the person’s current treating doctor – but there are many alternative practitioners who specialize in the technique. Several studies have already shown that the therapy has the potential to assist in relieving certain urinary symptoms.
Conclusion
Incontinence is a common complication that people with multiple sclerosis tend to experience. Some may experience only one type of urinary incontinence, while others may suffer from both types. Management includes lifestyle modifications, absorbent pads, and conventional treatments. Emphasis also needs to be placed on protecting the person’s kidneys, which helps to reduce the risk of urosepsis and related factors.
Dr. Ahmed Zayed, MD holds a baccalaureate of Medicine and Surgery. An avid contributor to the Huffington Post and Chicago Tribune, Dr. Zayed believes in providing accurate and accessible information to general readers. With years of writing and editing content in the medical niche, Dr. Zayed likes to think of himself as a man with a mission, keeping the internet free of false medical information.
References
- https://onlinelibrary.wiley.com/doi/abs/10.1111/ene.13010
- https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505252
- https://www.ncbi.nlm.nih.gov/pubmed/20828949
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565382/
- https://www.nationalmssociety.org/