Bladder problems caused by a disease such as multiple sclerosis (MS) is called neurogenic bladder. MS can disrupt communication between your brain and the bladder, making bladder problems quite common.

If you have multiple sclerosis (MS) and develop bladder problems, you’re not alone.

Most people with MS eventually experience some kind of bladder issue. Bladder dysfunction can be temporary or chronic. Treatment depends on your specific symptoms.

This article discusses how MS can affect your bladder, the symptoms, and what you can do about it.

Up to 90% of people with MS experience bladder dysfunction at some point. Symptoms tend to appear 6 to 8 years after you receive a diagnosis of MS. They can include anything from not being able to hold your urine to not being able to fully empty your bladder.

What does neurogenic bladder mean?

Neurogenic bladder is when your bladder problems stem from a disruption in signals between your central nervous system (CNS) and your bladder. This can be due to an injury or diseases such as MS.

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Yes. There are two sphincter muscles that help hold urine in your bladder. But your ability to control these muscles depends on nerves doing their job, which is to help your brain and your muscles communicate.

MS involves damage to your myelin, the substance that protects the nerve fibers in your CNS. The resulting lesions interfere with electrical signals, or messages, such as when your bladder is full. This causes the electrical signals to have trouble getting through.

Any lesions that affect your nerves and muscles that control your bladder can lead to neurogenic bladder.

MS affects everyone differently. Symptoms can come and go and change over time and may include:

  • increased urgency and frequency to empty your bladder (overactive bladder)
  • inability to fully empty your bladder (underactive bladder)
  • not knowing when your bladder is full
  • trouble starting or maintaining a urine flow (urinary hesitancy)
  • waking from sleep to urinate
  • loss of bladder control (urinary incontinence)
  • dribbling pee when you laugh, cough, or sneeze

Some complications of neurogenic bladder are:

Treatment depends on the specific problem, so it’s important to see a doctor or healthcare professional for a diagnosis.

Lifestyle and nonmedical treatments

You may be able to get bladder problems under control with a nonmedical approach. Habit retraining and other home remedies include:

  • Pelvic floor exercises: Pelvic floor muscle training helps tone and strengthen the muscles that affect your bladder.
  • Delayed voiding: This is when you hold off peeing for a bit to train your bladder to hold it longer, gradually increasing your hold time.
  • Avoid irritants: Try to identify and avoid potential irritants such as caffeine, alcohol, and tobacco that make the problem worse.
  • Stick to a schedule: Setting specific times to pee is another way to retrain your bladder.
  • Double voiding: After peeing, wait a minute, then try once more to empty your bladder.
  • Maintain a moderate weight: Extra weight can put pressure on your bladder.

Medication

There are several classes of drugs that can treat bladder dysfunction. Which type is right for you depends on the particular problem. These medications include:

Intermittent self-catheterization

If you have an underactive bladder, a doctor might suggest intermittent self-catheterization. This involves inserting a small tube into your urethra to drain your bladder. You may have to do this several times a day.

Tell a doctor if you have coordination problems that make this difficult.

Nerve stimulation

Percutaneous tibial nerve stimulation (PTNS) helps treat overactive bladder. It involves putting an electrode into your lower leg to stimulate the nerves. Treatment generally takes 30 minutes in a doctor’s office once a week and lasts 12 weeks.

Research suggests that PTNS in people with MS leads to symptom improvement by 12 weeks, or longer with a maintenance dose.

Surgery

The role of surgery in MS-related bladder dysfunction is limited. But when other treatments fail, surgical options may include:

  • surgery to remove stones or blockages
  • bladder augmentation, a procedure to increase the size of your bladder
  • cystectomy, or bladder removal surgery
  • urinary diversion, a procedure to create a new way for urine to pass out of your body and into a collection bag

What does neurogenic bladder feel like?

As with other symptoms of MS, it varies from person to person. You might notice dribbling, increased urgency, or having to pee more often than you used to. You might feel like you have to pee but can’t get it started. In general, you’re spending more time thinking about your bladder function and worrying about accidents than seems normal.

What is the ICD-10 code for neurogenic bladder caused by MS?

The International Classification of Diseases, 10th revision (ICD-10), is a coding system for medical procedures and diagnoses. Under ICD-10, neurogenic bladder related to MS would be coded as N319: “neuromuscular dysfunction of bladder, unspecified.” Medical coding helps determine whether certain procedures or treatments will be covered under a person’s health insurance policy.

Do Botox injections work for neurogenic bladder?

Maybe. In 2011, the Food and Drug Administration (FDA) approved Botox for MS-related bladder problems as an alternative to anticholinergic medications and surgery. A 2018 study suggests that Botox may improve urinary incontinence and quality of life in some people with MS. While it’s generally well tolerated, there are some potential side effects and risks. Be sure to discuss the pros and cons with a doctor.

Does MS cause you to pee more?

MS doesn’t affect your volume of urine. Not everyone with MS has a urinary frequency problem either. But you may feel the need to pee more often if your bladder doesn’t completely empty when you pee, you have an overactive bladder, or you have a UTI.

MS can disrupt communication between your brain and your bladder, making bladder problems quite common. Neurogenic bladder is the umbrella term for bladder problems caused by an injury or disease such as MS.

Untreated bladder problems can lead to serious complications. That’s why it’s so important to see a doctor and find out what’s going on. A doctor will recommend a treatment based on the specifics of your bladder dysfunction.