It may not be a well-known fact that approximately 80 to 90 percent of people who have multiple sclerosis (MS) have some problems with bladder function after being diagnosed. Typically, leakybladder in MS patients is of two varieties: keeping it in when you want to and getting it out when you want to. This usually happens when the bladder is small and overly active. Instead of expanding to hold the increasing amount of urine, the bladder will start to contract as soon as a small amount has been collected.

Part of the problem is the detrusor muscle in MS patients. When the bladder gets full enough, the nervous system tells the bladder muscle, called the detrusor muscle, to contract. If the muscle does not open, urine may not flow out of the bladder. Most people can usually keep the sphincter muscle closeduntil they reach the bathroom, at which point the sphincter relaxes in coordination with a contraction of the detrusor, and the bladder empties. When some part of this very intricate system fails, problems with a leaky bladder in MS patients begin.

As well, when the urinary sphincter keeps opening to let the urine out it will cause MS patients to experience intense and frequent urges to pee — sometimes as often as every 15 to 20 minutes. They may also experience dribbling or even the occasional flood.

Leaky bladder in MS patients usually presents itself with a sudden urge to urinate that is very difficult to delay and may be associated with leakage. Other features include:

• Frequency of micturition
• Nocturia (waking up during the night because you have to urinate)
• Abdominal discomfort
• Urge incontinence

If you’re having this type of bladder problem, and you have MS, contact your neurologist, urologist, or nurse specialist. They will have a few different treatment options to help calm the over active bladder. Several medications are available, so you and your healthcare professional can experiment to figure out which one will be the best for you and with the fewest side effects.

Today, there are many different options available to train the detrusor muscle in MS patients and leaky ladder problems in general. Some of these treatment options include bladder training, botox injections, tibial nerve stimulation. Primary care management for those suffering withleaky bladder syndrome are plenty. The initial management in primary care includes providing advice on lifestyle changes, pelvic floor exercises and bladder training. Depending on the severity of symptoms and the level of distress, anticholinergic drugs may be started immediately or added if the initial treatment recommended is not totally effective. If these options fail then referral to secondary care for further assessment and management should be considered.