Understanding the Link Between Multiple Sclerosis and Bladder Dysfunction

Multiple Sclerosis: What is it?

Before we delve into the crux of our discussion, let's first remind ourselves about MS. Multiple Sclerosis is a long-term condition that primarily affects the brain and spinal cord. It's an autoimmune condition where our immune system treats the protective covering of our nerve cells as foreign and launches an attack against it.

That protective covering, known as myelin, is vital for the smooth transmission of electrical impulses along the nerves. When myelin becomes damaged, it interrupts this transmission, resulting in an array of symptoms that vary significantly from person to person.

The Intricate Workings of the Bladder

What about the bladder? It may not seem like it, but our bladder is a rather sophisticated piece of biological machinery. A hollow muscular organ, it's designed to store urine from the kidneys until it's time to release it – a process controlled by a complex interplay between our nerves and muscles.

How does MS affect bladder function?

So, how does MS, a condition affecting the nervous system, interfere with bladder function? Well, the bladder's ability to fill and empty itself in a coordinated way heavily relies on an unscathed nervous system. As MS can damage the nerves that control these actions, it's not uncommon for people with MS to experience bladder dysfunction.

When we talk about bladder dysfunction in the context of MS, we're referring to a number of potential issues. These could include the inability to hold urine (urge incontinence), difficulty in emptying the bladder fully (urinary retention), or the need to urinate frequently (frequency).

In some cases, an individual might experience a mix of these symptoms. It's a complex issue, and its impact on quality of life can't be understated, particularly given the social stigma associated with bladder problems.

The specific symptoms experienced can offer some clues about which nerves have been affected by MS. For instance, an overactive bladder—manifested by urge incontinence or frequency—is often due to lesions in the brain or spinal cord interrupting the signals that control bladder function.

On the other hand, urinary retention could indicate that MS has impacted the nerves controlling the bladder sphincter's ability to relax and allow urine to pass.

Bladder dysfunction is not a rare offshoot of MS. In fact, it's reported that up to 80% of people with MS will experience some form of bladder dysfunction during the course of their disease. Recognising this is important because it destigmatises the issue and brings to light the importance of removing the taboo around it.

Management and Treatment Options

Now that we've established the connection between MS and bladder dysfunction, let's see what treatment is available:

See your doctor for diagnosis

Diagnosing bladder dysfunction starts with a detailed history of symptoms and often includes a physical examination. Further investigations may involve urodynamic testing to measure bladder pressures and urine flow rates, and in some cases, a neurological examination may be necessary to evaluate the extent of MS-associated nerve damage.

Discuss the variety of treatments available

Treatment strategies are as varied as the symptoms themselves. They can include lifestyle modifications, medications, and in some cases, surgical interventions.

Lifestyle changes might involve regulating fluid intake and scheduling regular bathroom breaks. Medications can be used to relax the bladder or tighten the sphincter. When these measures don't quite cut it, surgical options such as nerve stimulation or catheterisation might be considered.

Understanding Is Half the Battle

MS and its potential effects on the bladder can seem daunting but understanding what's happening and why is a significant step in managing bladder dysfunction and improving your quality of life.