Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 6833 msfocusmagazine.org MS can decrease quality of life through a variety of symptoms. Certain ones, such as fatigue and gait impairment, receive a great deal of attention, but one of the less-talked- about symptoms is urinary incontinence – an inability to store or empty urine within the bladder, often resulting in the involuntary leaking of urine. This is a serious symptom that can result in poor physical and emotional health, as well as embarrassment and withdrawal from social interaction. Because of the highly negative effects of urinary incontinence, awareness of available testing andtreatmentoptionsisincredibly important. Testing for incontinence The two most frequent causes of incontinence are the weakening of the urinary sphincter and incomplete bladder emptying. If you experience urinary incon- tinence to any degree, it is important to see a urologist. They can perform several tests that may identify the underlying cause and extent of issues. The tests they perform may include: • A urine culture – where urine is collected and tested. • A blood test – to establish proper kidney function. • Cystoscopy – where a small camera is inserted into your bladder. • Video urodynamics – the study of pressure and flow in the lower urinary tract. • A renal (kidneys) and bladder ultrasound – which can determine if the bladder is completely emptying or retaining urine. • Post-void residual urinevolume – measuring the amount of urine left in your bladder after urination. Finding the right treatment for you Finding a suitable treatment option is important, because urinary incontinence can lead to several serious conditions in addition to the discomfort and embarrassment you may experience. Women in a post- menopausal state can leak urine into the vagina, which may cause recurrent vaginitis. Falling can occur in situations where the floormaybecomewet, resulting in serious physical injury. Leakage, or the fear thereof, may interfere with healthly sexual expression. In many cases, disturbances in the nerve signals sent to the bladder or sphincter are the cause behind MS-related inconti- nence. However, a number of other MS symptoms can be contributing factors. Decreased mobility may be factor – especially when combined with speech limitations that may make it difficult to convey needs to one’s caregiver. However, even forthosewho remain mobile, other symptoms can play a part. For example, symptoms such as chronic fatigue, pain, or blurred vision may make it difficult for someone to respond to the need to urinate in a timely way. There are several options that medical professionals use to treat urinaryincontinence. Oralmedicationisapopularfirst-steptreatment (see box on page 35). But, if it proves to be ineffective, urologists may discuss other Symptom Management Help for Urinary Incontinence By Dr. Sardar Ali Khan and Yiji Suh “Awareness of available testing and treatment options is incredibly important.”