An outline of the management options for patients with MS who experience bladder symptoms, which usually arise due to spinal cord involvement
Author:
Collette Haslam, BSc, RGN, is clinical nurse specialist in uro-neurology, National Hospital for Neurology and Neurosurgery, London.
Abstract:
Haslam, C. (2009) Management options for bladder dysfunction in patients with multiple sclerosis. Nursing Times; 105: 40, early online publication.
In the UK today there are thought to be more than 85,000 people with multiple sclerosis (MS). Approximately 75% will go on to develop bladder symptoms, usually as a result of spinal cord involvement, which is a common feature of the condition. In the UK practitioners now aim to arrange management for each patient according to their individual needs and level of disability. This article outlines the various treatment and management options available.
Keywords: Multiple Sclerosis, Bladder dysfunction, Urinary incontinence
- This article has been double-blind peer-reviewed.
An outline of the management options for patients with MS who experience bladder symptoms, which usually arise due to spinal cord involvement
Introduction:
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (brain and spinal cord). The cause is still unknown but evidence to date suggests it has an autoimmune component which causes myelin damage. It is often progressive, leading to increasing disability.
Bladder problems in MS usually arise due to spinal cord involvement and, as the disease progresses and mobility deteriorates, it is not uncommon for bladder symptoms to worsen. The condition affects 100-120 people per 100,000 population and, of these, approximately 75% will develop urinary symptoms (NICE, 2003a).
The severity of bladder dysfunction is usually related to patients’ level of disability although there are exceptions. One feature of MS is that symptoms can vary in severity due to its relapsing/remitting course. A UK consensus for continence management was recently agreed by a multidisciplinary group involved in MS patient care (Fowler et al, 2009) (Fig 1).
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