How are bladder problems managed in multiple sclerosis?

Question

Hello, Doctor,

My uncle has been diagnosed with multiple sclerosis and has been struggling with bladder control and balance issues despite being on medication. He is finding it difficult to manage these symptoms in daily life, and he is not sure if they are signs of disease progression or side effects of his treatment.

Are there specific therapies or medications that could help improve his bladder function and balance?
Should he consider seeing a specialist, like a urologist or physical therapist? He is also worried about how these symptoms might impact his mobility and independence in the long term.
Are there exercises or lifestyle changes that could help strengthen his balance and pelvic floor muscles?
Additionally, how can we monitor if his current treatment is effectively slowing the progression of MS?
Is there anything else he should be doing to better manage these specific symptoms?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Bladder control and balance issues are common in multiple sclerosis (MS). While they can be due to disease progression, they may also be side effects of medication or result from muscle weakness and nerve dysfunction. He should inform his neurologist about all these side effects and may consider visiting a urologist as well. For urgency or frequency, medications like Oxybutynin, Solifenacin, or Mirabegron may be prescribed. For incomplete emptying, Tamsulosin can be used to relax the bladder neck. He can discuss these options with his neurologist.

In the meantime, I suggest he follow these guidelines:

Emptying the bladder at regular intervals to prevent urgency.
Reducing the intake of fluids, caffeine, and alcohol in the evening can help.
He can do Kegel exercises to strengthen pelvic muscles and improve control.
For his balance issues, he can seek physical therapy. If it worsens, he should consult with his neurologist, and a medication review will be needed.
A cane, walker, or ankle-foot orthosis may help prevent falls.

Regular tests (such as MRI and neurofilament light chain) and proper communication with the doctor are key to treating MS. It is important to provide updates to the doctor, ask all questions, and share everything.

I hope this has helped you.

Kindly follow up if you have more doubts.