I am a 27 year old woman with Multiple Sclerosis. As a part of my MS, I have developed bladder control issues. One problem I've been having is that I get the urge to urinate, I use the bathroom and 5 minutes later I have to go again and it's just a little bit. I don't always completely empty my bladder. The other issue is that if I feel like I have to urinate, sometimes I absolutely cannot hold it and I must go NOW! I am a teacher and cannot leave a classroom full of 8 year olds in order to run to the bathroom! If I sneeze or cough, I will "leak". I get embarassed because it's not like I can change my underwear in the middle of the day, and sometimes I walk around slightly wet, sraying myself with perfume down there to avoid the all telling odor.
I have spoken with my neurologist about this and he said the MS does cause these types of bladder problems, and he recommended I see a Urologist. The Urologist had mentioned possibly running some tests such as Uro-dynamic testing to see how quickly and completely my bladder empties. I would much rather attempt to strengthen my bladder muscles first. Can anybody tell me how to do these Kegel exercises?
Sorry to hear your going through all this. I will admit what I know about MS you could hold in a thimble, but my understanding with it is it has to do with nerve function.
I do know a bit more about the bladder and how it works for the fact I have what they refer to a "neurogenic" bladder. My bladder has NO nerve function due to nerve damage while having a hysterectomy 11 years ago. My bladder never regained function, so I have been "self cathing" for 11+ years. I was 32 at the time.
This is what I do know about the bladder, and how it works. For us to have the ability to pee, the bladder has to contract. This contraction comes from the nerve to the bladder. If there is a problem with the nerve function it can cause the bladder to not empty properly, in other words the bladder wouldnt contract hard enough to empty the bladder, which after awhile of having this residule of urine, eventually you will have sort of an "over flow" leakage going on and eventually have issues with infections ect..
Kegel exercises would only strengthen the pelvic floor muscles which is what my understanding is with them. It wouldnt help nerve function that I know of.
Now I'm not saying you definetly have nerve issues as being the cause of your problems it may have nothing to do with the fact you have MS and could be totaly unrelated, but in my opinion I dont think it would hurt for you to have an evaluation by a urologist and have uro-dynamic studies to determine the exact cause so you can choose what treatment would work best for you. Treatment for you may simply be intermintent self cathing to empty your bladder a few times a day which could possibly stop this leakage if that is the cause. But I just feel its in your best interest to have a full evaluation to know the exact cause, sometimes early intervention gives you the best outcome. Just my opinion of course.
I do wish you the best, and please let us know how you make out or what you decide.
Annette, first of all, let me say that I am sorry to hear about all of the issues that you have had. It sounds awful.
Second, thanks for responding to my question. I had talked to my neurologist about this and he said he definitely thinks it is from my MS. I've just gone through so much testing over the years that I haven't wanted to do any more. I think I will make an appointment with the Urologist though. In a way I feel kind of lucky because I've got a great urologist and I know he will lead me in the right direction.
What exactly is involoved in the uro-dynamic testing?
I think your making a wise choice by seeing a Urologist. I totaly understand your frustration with having so much testing over the years, being poked and proded. Unfortunatly for those of us with chronic illnesses, it becomes a way of life. In the last year and a half I have seen approx. 18 different Doctors, had several surgeries, and been diagnosed with several rare disorders, so I really DO understand.
I have had multipul Uro-dynamic studies at several different facilities over the years as you can imagin. Every facility has their own unique way of doing the testing, but will give the same results. I will try to give you the basic details so you will be fully informed as to what to expect.
First of all, "I" did NOT find it painful. Perhaps a bit uncomfortable, but NOT painful. As far as modesty, you need to cast that to the wind, however anywhere I have had this testing everyone has been totaly professional and shown great respect during any part of the test. First they will have you empty your bladder as much as you can, then they will use a catheter remove the rest. Then they will put this small (in diametor) very long catheter into your bladder, it will literaly coil around inside your bladder. This catheter has sencers on it so it can sence any sort of contraction within the bladder during the test. This is the part where depending on the facility with how they do this next step...Some facilities will then put another sort of sencer in your vagina, other facilities will put this in your rectum, it depends on their preference on how they do it. The idea with these sencers is it will find out if your straining any other muscles either in the rectum or vagina that may be the cause for your bladder being unable to empty. Again, this is unplesant, more embarassing than anything else, part of this testing. They will then fill your bladder with saline solution and will be monitoring anything these sencers are picking up. This will tell them at what point your bladder does contract, how hard it contracts, and with how full it is at the time ect.. (With me, these sencers never picked up anything at all, because as I said the nerve to my bladder is dead, so my bladder does not contract at all.)
Then they will have you try to pee, yes dispite all these tubes attatched. This will tell them just how hard your bladder contracts, and how much you are retaining after. Every place I have had testing has some sort of a urine catching system so dont worry about making a mess. One facility had a simulated toilet that you sat on, another had you in sort of a reclining position, with a catch basin, another had you stradel a catch basin, and yet another had you sitting at the edge of a bed with a catch basin. So it really depends on the facility as to what they have. You are in a gown the entire time, so your not exposed in any way other than when they are setting you up for the testing, and of course its a woman who will be at the very least present the entire time. For me it was a woman who also set me up for the testing. Basicaly thats the just of what is done, once they get the readings they need they will remove everything and your done, and will have an appt with the Urologist after for results.
As I said, the worst part of the testing is getting through the embarassment. I have had so many of these tests over the years, I no longer get worked up about it, but intionaly it was a rather dawnting process. Just keep in mind this is what these people do EVERYDAY. This is their profession, and are very professional , and conciderate the entire time.
I hope this graphic detail isnt too much for you to hear, but I am a firm believer in being totaly informed about anything I have done to my body. I believe that is what gives us the ability to be our own best advocates.
Elyse, I hope this helps, hope its not too graphic, and I do wish you the best. Feel free to ask any other questions , I will try to answer them if I'm able.