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Having lived with multiple sclerosis for a number of years, I’ve now been diagnosed with something called neurogenic bladder. Are the two conditions related?

Neurogenic bladder is the loss of normal bladder function caused by damage to part of the nervous system. Disorders of the central nervous system, such as Alzheimer’s disease, spina bifida, brain or spinal cord injury, multiple sclerosis, Parkinson’s disease and stroke can all cause neurogenic bladder.

Peripheral diabetic neuropathy nerve damage due to pelvic surgery, slipped disc and vitamin B12 deficiency may also cause the condition.

What are the symptoms?

The particular symptoms experienced will very much depend on the underlying neurological disorder, and can include an overactive or underactive bladder. Overactive bladder tends to produce frequent passing of very small amounts of urine, problems emptying the bladder completely and loss of bladder control.

Underactive bladder can result in the bladder becoming too full, leaking of urine and urinary retention. It can also cause difficulties starting to urinate, emptying all the urine from the bladder or recognising when the bladder is full.

All bladder problems can lead to the development of urinary tract infections.
Do I just have to live with it or can neurogenic bladder be treated?

Medications are available to help manage symptoms. These include drugs that relax the bladder in cases of overactive bladder or medicines that make certain nerves more active for underactive bladder.

Antibiotics are required where bladder problems lead to infections. A referral to a chartered physiotherapist with experience in the area of treating continence problems may help. They will be able to teach you special exercises (Kegel exercises) and provide other treatments to help strengthen your pelvic-floor muscles.
In certain conditions, including multiple sclerosis, there may be a need to use a urinary catheter. This is a thin tube that is inserted into the bladder.

It may be in place all the time (an indwelling catheter) or may need to be placed in the bladder four to six times a day to keep the bladder from becoming too full (intermittent catheterisation).
Surgery for neurogenic bladder may be recommended in some cases. It is important to learn to recognise the symptoms of urinary tract infection, such as a burning sensation when you urinate, high temperature, low back pain and an increased frequency of urination.

If you suspect you have developed a urinary tract infection, see your doctor, as antibiotics will be needed to clear the infection.