For patients dealing with bladder leaks related to Multiple Sclerosis (MS), a generous range of treatments are available – including lifestyle changes, physical therapy, medications and even therapeutic Botox. The emotional and physical effects of bladder leakage aren’t just something a patient must live with.

MS is an often-debilitating autoimmune condition of the central nervous system that impacts an estimated 2.3 million people around the world. The condition causes the immune system to attack myelin, the coating that protects nerves, creating lesions that interrupt brain signals. This can cause a diverse array of problems with vision, balance, energy level and can even cause paralysis.

Perhaps 80 percent of people who have MS have bladder issues. Lesions that interrupt communication between the brain and the bladder or urethra can cause bladder spasms, overactive bladder and other conditions. Patients may feel an urgent and frequent need to urinate and may sometimes be unable to get to a bathroom in time, a condition called urge incontinence. Similarly, MS can cause the bladder to retain urine or not empty completely, a condition called underactive bladder.

It’s important for people with MS to get treatment for bladder problems as soon as possible because the problem can worsen if not treated and may lead to kidney and urinary tract infections, among other things. Additionally, it’s important to consider the emotional toll of always being afraid of having an accident. Every aspect of life can be negatively impacted by bladder control issues.

How To Stop MS Bladder Leaks

There’s no substitute for medical advice, so anyone with MS-related bladder leaks should speak with a doctor right away. Medical professionals can offer choices and help patients decide what actions to take. In some cases, safe and effective Botox may be the best solution. For others, medication, lifestyle changes, exercise and more may be worth trying.

Here are some of the treatments a doctor may recommend to a patient with MS bladder leaks:

Fluid management. Asking a patient to limit how much liquid they consume is usually a bad idea, but adjusting the timing of liquid intake can help with bladder leaks. For example, a patient might want to drink less water in the hours before bedtime to help avoid nighttime accidents. It may require some trial and error to see what schedule is best.

Dietary adjustments. Some foods and beverages can impact bladder behavior, and reducing leaks may be as simple as reducing common bladder irritants from the diet to see if a pattern is present. For example, a patient may find their morning coffee irritating. Other common irritants include carbonated drinks, acidic fruit juices, tomato products and spicy foods.

Bladder training. The bladder muscles can be trained to better hold urine for short periods, reducing the urgency of the need to go to the bathroom. Bladder training can also include gradually increasing the time between voids to decrease the inconvenience of a frequent need to urinate. The process is slow but effective.

Pelvic floor therapy. Pelvic floor therapy can be successful for many patients with MS bladder leaks. A physical therapist can help determine where the pelvic floor is weak or tense and create an exercise plan. Exercises may include Kegels and other types of pelvic strengthening workouts, depending on need.

Medication. Patients with MS should not overlook medications that treat bladder leaks in others, which may work for those with bladder issues related to MS. These may include Darifenacin, Fesoterodine, Imipramine and a long list of other medications.

PTNM. A process called percutaneous tibial neuromodulation (PTNM) stimulates the tibial nerve with a needle inserted into the skin near the ankle. This process can be done in a medical office and uses the tibial nerve to help reinforce and normalize the natural reflexes of the bladder.

SNM. Sacral neural modulation (SNM) works similarly to PTNM but stimulates the sacral nerve through use of a neurostimulator implanted near the nerve. This device creates pulses that stimulate the nerve in an attempt to normalize the flow of messages between the brain and the bladder. Implantation can usually be done in a medical office without a hospital stay.

Intermittent catheterization. Some patients with problems emptying their bladders due to MS can benefit from intermittent self-catheterization. Once or twice per day, the patient can insert a small tube into the urethra to empty the bladder, preventing the bladder from becoming too full and reducing leaking, feelings of urgency and frequency.

Botox. Some patients are surprised that the same injectable product used for lines and wrinkles can be used to treat bladder problems – both in people with MS and in others. Botox relaxes muscles for up to 6 months when injected into the bladder. It can also block nerve signals that cause overactive bladder in a range of patients.

Botox is used every day by doctors, dentists and other medical professionals for bladder issues as well as teeth clenching, the jaw problem TMD, migraines, excessive sweating, foot pain, stomach problems and more. Well-trained Botox injectors understand both cosmetic and therapeutic uses for this injectable product.

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