Discussing bladder problems is never an easy topic of conversation, however Urinary Frequency, Urinary Urgency, Nocturia, Urinary Hesitancy and Bed-wetting; these are all symptoms many MSers will be familiar with to some extent.
Why is it that discussing health issues pertaining to toilet needs, leaves one feeling awkward? I’m sure it stems from years of schoolboy humour.
Simply put, frequent micturition is the need to urinate more often than normal.
Urinary urgency is the urge to urinate immediately. Nocturia is the nocturnal equivalent or bed wetting.
Not generally painful, but it can be very inconvenient. For many months I would not travel anywhere.
However, these bladder problems can be very painful. Mine got so bad, that I was in excruciating pain. I could not function. It was not even possible to sit and watch TV.
All that I could do was to go to bed and take a very strong sleeping tablet. After consulting my neurologist, I was referred to our local urology clinic for investigation.
In MS, the urge to urinate is often not actually accompanied by any urine to pass. It is just a rogue sensation, another nerve that is producing a wayward signal.
A frequent problem in MS is the inability to fully empty the bladder. Leaving urine in the bladder can lead to infection and will at least cause some discomfort.
To this end, and to my horror when my MS nurse first suggested it, I now self catheterise every day.
Urinary Hesitancy is another symptom. You may feel an urgent need to pass water. But, find that you cannot urinate.
While these symptoms can be indicative of multiple sclerosis, there are other possible causes. In men it could be a sign of an inflamed prostate gland or, God forbid, prostate cancer. It is simple to treat urinary tract infection (UTI) if required.
Your doctor may recommend you having a cystoscopy. This is a procedure to insert a camera into the bladder.
I have undergone this procedure, it is not painful, although it is a little embarrassing.
- Anticholinergics (e.g. oxybutynin or tolterodine). Desmopressin may be used for night problems or to control urinary frequency during the day. But, should never be used more than once in 24 hours.
- The use of a bladder stimulator can help.
- Continued incontinence, despite treatment, can be treated by a course of pelvic floor exercises. Preceded by a course of electrical stimulation of the pelvic floor muscles.
- Continued bladder problems may require intermittent self-catheterisation or for longer-term urethral catheterisation.
A Final word on Bladder Problems
I have ceased using the catheter to empty the bladder; it was causing infection despite thorough hygiene care.
I am still very cautious with travel as the urinary urgency can still strike without warning. I now use incontinence pants to mitigate any possible embarrassment.
Doubly embarrassing is the fact that the most easily available incontinence pants are Tena Lady from the local supermarket.