Understanding MS Bladder Issues and How ISC Can Help

Multiple sclerosis (MS) can cause bladder problems like incontinence and urine retention, but intermittent self-catheterisation (ISC) can help solve them. Learn more from Shauna Brady, a registered nurse specialising in MS symptom management.

Read about the urinary issues associated with MS and how ISC can address them.

Shauna Brady is a registered nurse who focuses on helping patients with MS manage their symptoms. She recently spoke with Hollister to share how she supports people with MS, to help them improve their quality of life. “There is a lot more awareness of the condition than there used to be, with all kinds of fundraisers and celebrities opening up about their experiences,” she says. “Research is advancing and new treatments are available – but there is still a ways to go.”

Discovering the connection between bladder problems and MS

“Many people with MS have bladder symptoms – whether that’s dealing with urinary urgency, frequency, incontinence, or retention – but they often don’t realise that they are experiencing these problems because of their condition,” says Shauna. “They might think it’s because they’re getting older or they’ve had a baby or they’re going through menopause; that’s why people may not even bring it up when they come to our clinic on a referral from their neurologist.”

Shauna finds that “having a long chat” with patients often results in them bringing up their bladder problems. Once she tells them that their urinary issues may be caused by their MS, many of them have an “ah ha!” moment. “I believe that MS patients need more education about how their condition can affect their bladder, says Shauna.

Talking about anatomy and bathroom habits

To help patients better understand how MS is causing their bladder issues, Shauna has found that discussing how a healthy urinary system operates is helpful. “With a new patient, this education on anatomy is so important,” says Shauna. “Before we look for solutions, they need to understand how things should work – and why they’re not working right for them.”
 

Another topic that Shauna discusses is bathroom habits. “I talk about the urine stream and point out that if they use the toilet every hour, the stream will be weak because they’re not giving their bladder a chance to fill,” she says. She also talks about urgency. “I ask – can they hold urine in, or do they have to hurry to the bathroom?” she says. “And I also talk about urine retention; if they’re not draining their bladder completely that may be why they’re having frequent urinary tract infections.”

Shauna also offers them practical tips. “I like to talk about things such as fluid intake, and why water or other caffeine-free fluids are best if they want to avoid irritating their bladder,” she says.

Learning about neurogenic bladder disorder

Shauna not only teaches her MS patients about the urinary system and finds out about their bathroom habits, she also educates them about neurogenic bladder disorder. A person with a neurogenic bladder has some type of bladder control problem caused by an injury or by an illness of the nerves, spinal cord, or brain. Below are some key points she tells her MS patients about this condition:

• In a healthy individual, the detrusor muscle lining the bladder wall fills and stretches; then it goes from this relaxed state to contracting – which leads to urination
• A neurogenic bladder results in the detrusor muscle failing to completely empty the bladder when it contracts
• A neurogenic bladder can cause urine to be retained, potentially contributing to an increased risk of urinary tract infections

Shauna may do a bladder ultrasound on a patient to see if they are retaining urine in their bladder.

Performing ISC to improve quality of life

“All of this education and explanation helps prepare my patients to try intermittent self-catheterisation; I truly believe that ISC can liberate people, and I always give specifics about how it could improve their lives,” Shauna says. “For instance, some people might not want to go on a hike unless they know there will be toilet facilities nearby, but if they can perform ISC before leaving they can go on that hike. They can keep up their social lives and see their friends, knowing their bladder has been fully drained.”

Shauna is also keenly aware of what MS patients fear the most — a lack of control. “Not having any control over their condition is their biggest fear, but with ISC they can control their bladder symptoms,” she says. “They can decide when and how to do it, and gain independence and control in an unpredictable world. Once they realise the benefits that come with it, ISC can be life-changing for them.”

 

 

Shauna Brady is a registered nurse specialising in symptom management for multiple sclerosis (MS) patients in Alberta, Canada. Ambitious and keen to offer the best care possible, Shauna studied and qualified as a nurse continence advisor and then later as an MS-certified nurse. Her care helps people with MS manage all types of physical and lifestyle issues.

Shauna received compensation from Hollister Incorporated for her contributions to this article.