b'Symptom ManaGementTThheeEEeeccttssooffMU MSSoonntthheeUrriinnaarryyBBllaaddddeerrA Guide to SymptomManagementBy Dr. Ruchira Singh, FACOG;Monica Major-Harris, ARNP, FNP-BC;and Eliza Rivera, PT, DPT, WCSMultiple sclerosis is a leading cause of urinary stream, straining to urinate, or feelings ofproblems (lower urinary tract dysfunction) incomplete bladder emptying. in patients with neurological disorders. It MS can also cause inability to empty thecontributes to both difficulty holding and bladder (urinary retention) that can occur inemptying the bladder. Urinary dysfunction is six to 49 percent of patients. About 56 percentconsideredoneofthemostbothersome of patients with MS may experience leakingsymptoms withMSandcangreatlyaect of urine with coughing, sneezing, and changingquality of life.positions (stress urinary incontinence).Bladder Stats Approximately 50 percent of patients with Typically,patientsreportsymptoms MS can experience both diculties storingapproximately six to eight years after initial urine and emptying the bladder retentionMS diagnosis.simultaneously.However, one in 10 individuals will present Urinary problem managementwith urinary symptoms at initial MS Management of urinary problems indiagnosis.patients with MS often requires a consensual Approximately 80-100 percent of patients approach, and cooperation between dierentwill have some type of urinary dysfunction medical professionals. The rst step is to seeby 10 years after initial diagnosis.a urogynecologist or other specialist who istrainedinthemanagementofurinaryThe symptoms may vary in severity and dysfunction.Initialassessmentincludesatype, and may deteriorate as the disease detailedhistoryandathoroughphysicalprogresses. Patients with MS most frequently exam. Your medical provider may test yourreport difficulty holding or storing urine, urineforinfectionandassesshowmucha.k.a. overactive bladder. These patients can urine is left in your bladder after urinating.experience a strong urge to urinate (urinary Additional testing may be needed to gain aurgency), frequent urination (urinary frequency), better understanding of this complex issue.and urinary leakage with the urge to void These may include blood-testing, ultrasound(urge urinary incontinence). Some patients of your kidneys or a complex procedure towillalsoexperienceweakorinterrupted check how your bladder functions. msfocusmagazine.org 8'