Bladder spasms in multiple sclerosis (MS) are related to urinary incontinence. The symptom is a result of damage caused by the disease that leads to interrupted signals between the spinal cord and brain, which can affect a wide range of bodily functions, including bladder function. As signals between the brain and central nervous system break down or become delayed over time, the bladder can spasm randomly or uncontrollably.
What is a bladder spasm?
Also known as a “detrusor contraction,” a bladder spasm happens when the bladder itself contracts or shrinks involuntarily, leading to incontinence. The sensation is similar to the sensation experienced when people purposely void, or “let go” of urine. But with bladder spasms, the patient does not have control over the contraction.
Bladder spasms such as these are symptomatic of a “neurogenic bladder,” which is caused by a number of diseases and conditions, including MS.
How are bladder spasms in multiple sclerosis treated?
Multiple sclerosis bladder spasms are treated along with other symptoms and conditions related to bladder dysfunction. After ruling out a urinary tract infection as the cause of the spasms, physicians will often seek to treat the symptom with non-invasive interventions first, such as changes in diet and a bathroom schedule to keep the bladder as empty as possible — particularly when planning to travel.
Next steps in treating an overactive bladder are often based on whether the patient is effectively emptying their bladder. If patients have less than 100 ml of urine in their bladder at the time of testing — considered a low volume — an overactive bladder is typically treated with medications to decrease frequency and urgency. However, if volume is high — more than 100 ml — that level of bladder retention may require patients to use self-catheterization to ensure the bladder is fully emptied before taking medication to control overactive bladder symptoms.
A newer therapeutic approach to controlling an overactive bladder and spasms in MS is the use of Botox (botulinum toxin), which is injected directly into the bladder wall. While Botox injections are not a permanent solution to an overactive bladder, they have been found to manage the symptom for six to 10 months. However, the treatment often requires self-catheterization after administration.
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