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    I appreciated Janet DeClark's lecture regarding cognitive changes in MS. Regardless of whether changed occur due to age or MS, Janet offered helpful suggestions on how to manage such changes. She did so in a sensitive, caring way.

    Julie H., JUMPSTART Program Participant
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    by Pat Kennedy RN, CNP, MSCN, Can Do MS Nurse Educator & Programs Consultant

    How well do you know your bladder? If you have MS and are experiencing some changes in your bladder function, you have a great deal of company.  Probably 85% of people with MS will experience problems with bladder function at some time in their course of MS.  It has personal and medical implications and is a symptom of MS that actually has a number of strategies to help.  It is helpful to know a little about why this is such a commonly seen symptom.  It is also helpful to know that bladder dysfunction can occur because of other problems as well so needs to be discussed with your family doctor, your neurologist or your gynecologist.

    Bladders are told what to do by the brain and spinal cold.  Peripheral nerves at the bladder send information to the spinal cord and brain.  When brain, cord and bladder nerve s are working well, function is normal, but when MS causes lesions in the brain and cord, transmission of messages is slowed or interrupted causing you to experience symptoms. Why is this an issue?  Symptoms can be inconvenient and uncomfortable and can intrude on your life style.  You might have infections in either the bladder or kidneys or both.  You can develop increased pressure in your kidneys causing major health issues. Problems can decrease your self esteem and can force you into isolation.

    Bladder dysfunction falls into 3 categories.  They are:

    • Storage dysfunction
    • Emptying dysfunction
    • Combined dysfunction

    The symptoms for each can be similar so it is difficult to immediately know which type of problem you have.  It is good to keep track of your symptoms and share them with your health care provider so that appropriate treatment can be initiated.

    Storage problems occur when the brain is not able to allow the bladder to fill causing the bladder to empty frequently but completely.  Symptoms include urgency, frequency, urge incontinence and few, if any, bladder infections. 

    Emptying dysfunction occurs when the messages to the bladder and its sphincters are slowed or absent so the bladder does not know it needs to empty or may not empty completely. Symptoms include frequency, urgency, urge incontinence, incontinence without urge, hesitancy, slow urine stream and history of bladder infections.

    Combined dysfunction is a lack of coordination between the bladder muscle and the sphincters.  This often traps urine in the bladder.  Symptoms include urgency, hesitancy, dribbling, incontinence and infection.

    If you experience any of these symptoms on a regular basis, talk with your provider. Depending on the symptoms, he or she might recommend a medication, a change in lifestyle, or a referral to an urologist. 

    So, bladder problems are an issue in MS but relief is available.  Start keeping track and asking questions of your provider.  Your good health and quality of life depend on it!

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