Urinary retention in multiple sclerosis (MS) is a common byproduct of bladder dysfunction, and is characterized by an inability to completely empty the bladder. There are both acute and chronic (temporary and lasting) forms of urinary retention, which can be caused by a wide range of other issues, such as benign prostatic hyperplasia (an enlarged prostate) in men, a urinary tract infection, or issues with the muscles that control urination. In the case of MS, chronic urinary retention is often cased by the latter, since the disease’s attack on the nervous system often impairs signals from the body to the brain and vice-versa, leading to a host of bladder and bowel issues.
It is important for multiple sclerosis patients to address urinary retention, since retaining urine can lead to both urinary tract and skin infections. In addition, urinary retention can exacerbate other symptoms directly related to multiple sclerosis. Muscle weakness and spasticity — both hallmark MS symptoms — can be enhanced due to urinary retention, along with the development of kidney stones and an overall decrease in the quality of life.
How is Urinary Retention in Multiple Sclerosis Treated?
MS specialists seek to improve quality of life and offer symptom management in addition to halting the progression of the disease. Fortunately, urinary retention is both treatable and manageable.
Initial interventions are minimally invasive, and include diet and fluid intake alternations, as well as bladder training and planned visits to the bathroom. Medications may also be prescribed to address bladder dysfunction if lifestyle changes are not effective.
In addition to prescribing therapeutics, a physician may also suggest pelvic floor physical therapy, which helps strengthen the pelvic muscles and can greatly improve bladder control. Other options include percutaneous tibial nerve stimulation (PTNS), which utilizes a small needle electrode inserted into the ankle during 30-minute sessions. This electrode stimulates a network of nerves that controls the bladder and pelvis muscles, called the sacral plexus, and can help improve bladder function. There is also a device known as InterStim, which is surgically implanted under the skin and automatically stimulates the sacral plexus on an ongoing basis.
More invasive approaches to addressing more serious cases of urinary retention in multiple sclerosis include intermittent self-catheterization (ISC), which allows MS patients themselves to insert a thin tube into the urethra to empty the bladder.
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