Trouble with bladder control is common for people with MS. But it doesn’t have to take over your life. With the right approach, you can get a handle on these issues.
Types of Bladder Control Problems
There are a few versions that affect people with MS:
- Urinary urgency means you feel the need to pee often and urgently. The small "tickle" and feeling of pressure that help us know it’s time to head to the restroom are intense.
- Incontinence is the loss of bladder control. Sometimes, MS will disrupt the nerve signals that direct the movement of urine in your body so that it comes out when you’re not ready.
- Nocturia means you have to get up a lot during the night to go to the bathroom.
- Urinary hesitancy is when you have trouble starting to pee.
Bladder Control Treatments in MS
A bladder problem is more than an inconvenience. Without treatment, it can turn into other health issues, including bladder infections, kidney damage, and hygiene problems. It also can keep you from doing the things you’d normally do and make you feel isolated.
Talk to your doctor if you notice any changes in when and how often you’re going to the bathroom. They might recommend that you see a doctor who specializes in bladder problems, called a urologist. They might also talk to you about some things you can do on your own:
Diet changes. One way to start is to change the liquid you put into your body every day. Your doctor may recommend that you:
- Drink no more than 2 quarts of liquids a day.
- Drink a small glass of water (about 6 to 8 ounces) all at once every few hours. That's better than sipping drinks constantly, which might make you want to pee more often.
- Stop drinking at least 2 hours before you go to bed.
- Steer clear of drinks with caffeine, such as coffee, tea, and sodas.
- Have no more than one alcoholic drink per day.
Change your behavior. Some things you can try:
- Bladder training aims to let you go longer between your trips to the bathroom. You start by setting a schedule for when you’ll pee. Then, you train yourself to resist the first urge to go and keep from going until your scheduled time. Eventually, the time between restroom visits lasts several hours.
- Timed voiding helps people who have a condition that makes it hard for them to get to a bathroom in time, such as a physical disability. The person follows a schedule with set times to visit the restroom. This method doesn’t try to teach the person to resist the urge to go.
- Prompted voiding trains a caregiver to remind someone to go to the bathroom. The goal is to have fewer accidents by making the person aware that they need to pee every so often. People often use timed voiding at the same time.
- Kegel exercises strengthen the pelvic floor muscles, which help with bladder control. Your doctor can tell you how to do them.
- Avoiding tobacco. Nicotine can irritate your bladder and increase the urge to go. Ask your doctor for help quitting.
Absorbent products such as mini-shields that attach to underwear or plastic-backed diapers. These items help you guard against accidents. Most of them are disposable, but you can also buy absorbent cloths that you can wash and reuse.
Medications. If behavior changes don’t work, your doctor may prescribe medicines to help with bladder control. You might also take them while you keep up your behavior training.
These drugs help control muscle movements that force urine out of the bladder:
- Darifenacin (Enablex)
- Fesoterodine (Toviaz)
- Imipramine (Tofranil)
- Oxybutynin (Ditropan, Gelnique gel, Oxytrol transdermal patch)
- Solifenacin (Vesicare)
- Tolterodine (Detrol)
- Trospium (Sanctura)
Mechanical aids such as:
- Catheters. Your doctor can put this thin, flexible tube through your urethra, the tube through which pee leaves your body, and into your bladder to drain urine.
- Urethral insert. A thin, flexible solid tube in the urethra that blocks the flow of leaking urine.
- External urethral barrier. A self-adhesive patch you can put over the opening where urine comes out.
Surgery. Doctors usually recommend an operation only as a last resort when other treatments haven’t worked.