One of these is ‘loo taboo’ as it is a potentially uncomfortable issue to raise. Changes to bladder function effect both men and women and you should always be asked about your bladder function this when you see your MS team.
It is statistically likely in many centres in NZ, with the gender mix of our doctors, that you will end up seeing a male neurologist and if you’re a woman with MS this may play a role in under reporting. In addition many women who have gone through childbirth tend to attribute bladder changes and light bladder leakage to the rigours of pregnancy; something that needs to be accepted while avoiding jumping on the trampoline with their children.
Bladder over or underactivity in MS is related to the pontine micturition centre in the brain and its communication to the bladder nerves in the spine causing either overactive symptoms: urgency and frequency or an underactive bladder: incomplete emptying, straining and urine retention.
Overactive bladders want to be emptied frequently and trigger the need to get to the toilet urgently, which can lead to not making it in time, which in turn causes anxiety and embarrassment. If you have an overactive bladder, it is likely you will know where all the best public toilets are situated. You may carry a spare pair of underwear for ‘just in case’ moments and you’ll potentially reduce your fluid intake before going out. As a guideline you should need to empty your bladder about every four hours, so if you empty your bladder more frequently or if you wake to empty your bladder more than once overnight please do consider sharing these details with your MS team or GP.
An underactive bladder often means having problems coordinating its sphincters to empty fully which in turn leads to a greater risk of urinary tract infections. As you may already know, infections are the enemy of MS as the increase in body temperature can bring about the return of previous MS symptoms (a pseudo relapse). Someone with an underactive bladder will notice UTI’s and the feeling that they need to apply pressure on their abdomen to clear the urine.
Completing a bladder (or bowel diary depending on your issue) can be helpful to track exactly what is happening.
To help raise this issue an MS bladder check has been developed by Coloplast. There is a new Australasian bladder bowel and sexual function publication now available from www.hollister.co.nz who also have a bladder function webinar, Multiple Sclerosis and the Urinary System | Hollister NZ which you may find a quick and interesting watch. Bladder and Bowel Health at Continence NZ is a great resource.
You should always be asked about your bladder function when you see your MS team and if for some reason you are not and you have concerns please feel confident to raise this.
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