The best way to understand catheters is to understand how your bladder works.
Your kidneys make urine and send it to your bladder. When everything’s working well, your bladder stores the urine until there are about 4-8 ounces inside. At that point, the nerves in your bladder send messages to your spinal cord that say, “It’s time to pee.” Your spinal cord relays that message to your brain. And you head to the bathroom.
The reason you’re able to pee is because your brain and spinal cord tell your voiding reflex to go to work. That’s when your bladder muscle pushes out the urine, and your external sphincter muscle opens so the urine can come out.
When you have MS, lesions on your brain and spinal cord either stop or slow the messages to your bladder muscle and sphincter. This means, as the disease gets worse, you may:
- Find it hard to control when you pee, also called incontinence
- Feel like you have to pee really badly
- Feel the need to pee often
- Have a hard time starting to pee, or keeping it going once you start, also called hesitancy
These are common side effects of MS: Bladder issues happen to about 80% of people who have this condition.
If urinary issues start to cause problems with your health and quality of life, your medical team may recommend a catheter, or thin, hollow tube that drains urine from your bladder.
What Can I Expect From a Catheter?
There three catheter options, one of which is temporary:
Intermittent self-catheterization (ISC). This temporary option is the one you control yourself. It’s best if you have good eyesight and full use of your hands. Using a disposable catheter, you insert a thin tube into your urethra and draw off the urine into the toilet. This is something you do many times a day, as needed.
ISCs may take some getting used to, but your health care team will show you how it’s done. With practice and patience, it’ll become second nature.
Indwelling urinary catheter. This long-term catheter goes through your urethra and into your bladder. A small balloon on the bladder end keeps the catheter in place. On the outside of your body, the tube either drains into a collection bag or has a valve that helps you store the urine in your bladder so you can release it right into the toilet.
Suprapublic catheter. Instead of going through the urethra, a suprapubic catheter is surgically put into your bladder through your abdominal wall, just below your navel. Like the indwelling urinary catheter, the urine is either directed to a collection bag or is held in your bladder with a value that you release into the toilet.
What Are the Benefits of a Catheter?
Keep infection risks low. Urine is made of water and waste products. If your bladder won’t empty completely, urine stays in your bladder too long. This can cause repeated bladder or urinary tract infections (UTIs).
These infections can cause your body to pee more and increase your need to pee so often you lose sleep overnight. If left untreated, UTIs can cause a bad infection or sepsis and death.
Long-term kidney health. UTIs increase the amount of pressure your body puts on your kidneys. Over time, if they’re not treated or they resist medication, it could lead to kidney failure.
Pee that stays in your bladder too long can also leave mineral deposits that form painful kidney stones.
Long-term bladder health. Your bladder is an elastic-like sac. When it isn’t able to release all your pee, it may distend, or stretch out too much. A stretched-out bladder can’t hold as much pee and will increase your trips to the bathroom.
Lessen the risk of worsening your MS symptoms. Bladder issues, and the medications that go with them, can make some of your MS symptoms worse, like spasticity and weakness.
Keep your independence. When you need to pee often, or you get repeated infections, you may feel tied to the bathroom and sidelined by side effects. This can impact your career, social life, self-esteem, and ability to go where you want, when you want.
Are There Any Risks?
To avoid getting an infection, it’s important to wash your hands before and after you catheterize yourself or transfer urine from the valve or bag into the toilet.
Follow the instructions from your medical team, and don’t be afraid to ask questions if there’s something you don’t understand.
What’s the Best Way to Live With My Catheter?
To avoid having to catheterize yourself, or empty your collection bag too often, you may be tempted to limit your fluid intake. But that will cause additional health problems.
Use these workarounds instead:
- Don’t sip. Drink 6-8 ounces of fluid at a time throughout the day.
- Plan to pee 1.5-2 hours after drinking.
- Unless you’re very thirsty, don’t drink anything 2 hours before bedtime.
- Pee immediately before you go to bed.
- Steer clear of bladder irritants, including smoking, caffeine, alcohol, and the artificial sweetener aspartame.
