If you landed here first and would like to go to Bladder Problems - Part 1, click here.
As I said at the end of part 1, there are three basic things that can go wrong when you have MS.
Bladder Problems - Part 2
- Failure to store
- Failure to empty
- Combined dysfunction
Failure to store
When you have this problem, demyelination has occurred between the spinal cord and the brain. The bladder is also usually small and spastic. As a result the bladder fills up quickly.
The messages sent to the spinal cord can't be transmitted to the brain. Why? Demyelination.
All of this leads to repeated signals from the spinal cord. You would experience symptoms of urinary urgency or having to get to the bathroom quickly.
You could also probably have urinary frequency. This is feeling the urge to go even though you just went. Another symptom you may have is dribbling where you can only urinate only a small amount of urine at a time.
Incontinence or wetting yourself is something that can also happen. If those aren't enough you may also experience nocturia, which is having to wake up during the night to go to the bathroom.
Failure to empty
Your MS can cause failure empty urine. When this happens demyelination has occurred somewhere along the voiding reflex are in the spinal cord.
Your bladder fills up, but because messages can't be sent from the spinal cord you can't empty. Your brain never gets the message that you bladder is full. The sphincter muscle can't relax.
Your bladder becomes too full. This causes what is called a large. over-distended, flaccid or atonic bladder. Many of the same symptoms that occur in failure to store can also happen in this case. You can have urinary urgency, dribbling, incontinence, as well as hesitancy.
In this type of dysfunction, you would have both of the above bladder problems. This is called detrusor-external sphincter dyssenergia or DESD.
This combined dysfunction is the result of a lack of coordination. The detrusor and the external sphincter contract at the same time. This causes urine to be trapped in your bladder.
You have to go to the bathroom, so there is urgency and there is hesitancy because you can't. You can dribble and you can also have incontinence.
It's important that you go to the doctor if you have any of these symptoms. Urgency, hesitancy, dribbling, or incontinence, can be the result of any one of the bladder problems we've talked about so far. Cir's doctor found out that he had failure to empty.
He has always had bladder problems. Even as a teen he urinated slowly. Kids used to tease him because he took so long to go to the bathroom. When his urologist first discovered his dribbling problem, he prescribed Flomax for Cir.
The medication helped for awhile. He was able to empty his bladder, though it still took awhile. The symptoms were reduced so that he could function at some level of normality.
To read more about Bladder Problems, go to Part 3.
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