Bladder problems with MS

Here at we get asked a lot about ways people can better manage their bladder dysfunction.  With bladder problems occurring in 80% of people with MS we think it’s a good topic to re-discuss. Bladder dysfunction can play such a major part of limiting peoples independence, self-esteem, increasing fatigue and reducing long-term health.

Bladder Dysfunction occurs due to the damage to nerves signals and their inability to communicate the correct message from the brain to the bladder and urinary sphincter.

Identifying what kind of bladder dysfunction you might be dealing with helps in order to take the right steps towards limiting the effects it has on your daily life. Unfortunately some of us have more than one issue to deal with.

  • Urinary Urgency People with this problem feel the need to urinate frequently and urgently. That familiar "tickle" and pressure that help us recognize the right time to head to the restroom is unusually intense. When urinary urgency takes place, the signals that synchronize urination are disrupted which creates an uncontrollable urge to urinate—the very definition of incontinence.
  • Nocturia People with nocturia must awake frequently during the night to go to the bathroom. There are a number of causes for this type of incontinence, but persons with MS may experience nocturia due to the interruption of brain impulses that travel up and down the spine to coordinate urination.
  • Urinary Hesitancy - This refers to difficulty initiating urination. With multiple sclerosis, this problem may be caused by interruption of brain impulses that control that part of the urination process.
  • Sphincter Dyssynergia - Another common problem seen in a bladder affected by MS is sphincter dyssynergia (SD). This occurs when there is both a storage dysfunction and an emptying dysfunction. The bladder is trying to contract and empty, and the urethra is contracting instead of relaxing, therefore allowing little or no urine to pass. This phenomenon is usually due to nerve damage in the spine as opposed to the brain.
  • Underactive Bladder - The nerve damage occurring from MS can cause the bladder to weaken, and as a result, the bladder may not contract to release the urine. If nerve signals from the bladder cannot tell the brain to empty, the bladder continues to fill and expand. Eventually, it overflows, with leakage of urine (i.e., overflow incontinence). Even if urination occurs, the bladder usually does not empty completely, resulting in urinary retention.

If left untreated, bladder control problems can cause other health concerns, including:

  • Repeated urinary and bladder infections or kidney damage
  • Personal hygiene problems
  • Interference with normal activity, leading to isolation

A Urinary tract infection is an infection of the kidney, ureter, bladder, or urethra. Abbreviated to UTI.

Why are people with MS more prone to UTI’s?  

As discussed the bladder is not functioning correctly resulting often in the bladder holding onto urine and never fully emptying the bladder.  This then creates a “stagnant pond” effect, which allows infections to grow. Catheter use also increases the risk of introduced bacteria. Steroid drugs can also weaken the immune system and make it harder for the body to fight the infection.


What are the Common signs of a UTI:

  • Fever
  • Urinary incontinence/leaking around the catheter
  • Cloudy urine
  • Spasticity
  • Back pain
  • Bladder pain
  • Lethargy
  • Painful or difficult urination
  • Sudden, high blood pressure
  • Increased weakness
  • Any worsening MS symptom



If you have a UTI or suspect one, go to your GP that day and discuss your options, most likely you will need antibiotics.

Urinary Track infections are debilitating with MS and once one is present you have more chances of getting more.  Preventative measures can help with stopping re infection.

 Preventative measures  

Be aware of the symptoms of a UTI and watch for them.  If in doubt do a self bladder test from  A supplement to help maintain the healthy binding ability of E. coli bacteria in your bowel is essential.  MS Bladder Boost (a prescription is not needed) will provide this.

Drinking plenty of clear fluids, keeping your personal hygiene to a high level, avoiding tight fitting underwear and pants and eating a diet high in fibre to maintain bowel function.

Treatment options for Bladder Dysfunction

There are a number of options available to make living with MS bladder dysfunction manageable.  Incontinence clothing and pads have drastically improved and are available in most supermarkets an online. MS Biotin Boost (prescription is not needed) supplement has been identified to help many manage better bladder control. Prescription medication to manage symptoms are also available an improving, it is important to discuss these with your specialist.


Where to start?

Take control of your bladder an accept that it isn’t working properly but that options are available to help manage and regain confidence.  To do this you could start a bladder diary, to record what is happening, download the PDF here: Bladder Diary - Urology Ca#1DF3. 

Book an appointment with your specialist, they may refer you to a Urologist who will run tests to establish a treatment plan.  Once you have established that something can be done you will feel lot better. Be mindful that as your MS changes so could your bladder dysfunction so don’t think it’s a one time checkup.