Bladder Incontinence, Urgency, Retention, Nocturia & Hesitation

This is a common trouble area that most people with Multiple Sclerosis don’t like to talk about because let’s face it, it’s embarrassing! That doesn’t change the fact that it is very common, for example, according to WebMD, about 80% of MS patients deal with incontinence. So let’s define the different bladder symptoms:

Bladder Retention

The feeling of needing to “go” with the inability to actually “go”. Basically, the signals that are sent to and from the brain which control the muscles involved in emptying the bladder become interrupted causing the patient to become unable to empty their bladder at will even when they feel their bladder is full.

Bladder Incontinence

The inability to “hold it”. For the same reasons as above, patients are unable to “hold it” which often results in embarrassing incidents.


A sudden feeling to urinate which presents very often even if the you don’t have to actually go much at all. One second you feel fine and the next second you have to go to the restroom 5 minutes ago. This obviously can lead to incontinence…


The need to wake up frequently throughout the night to use the restroom.

Urinary Hesitancy

Difficulty initiating urination.


It is important to treat the above problems as leaving them untreated can result in urinary tract infections (UTI’s) or even kidney damage! Here are the most common forms of treatment.

Dietary – Try to reduce the amount of liquid you intake, some suggest around a little less than 2 liters a day. This should be discussed with your doctor as some people may need more water than others. Don’t drink caffeine and avoid alcohol, definitely no more than one alcoholic drink a day! Caffeine is a diuretic (promotes the production of urine) and a bladder stimulant. Alcohol inhibits the production of “anti-diuretic hormone” (ADH) which tells the kidneys to re-absorb water and if they don’t re-absorb water then the body must void it.

Habbit Training – This can involves setting a schedule and trying to stick to it in attempt to lengthen the amount of time you can go without using the restroom. The amount of time between each trip to the restroom is increased over time. Setting a schedule can also help with incontinence, by setting a schedule, you know you have to head to the restroom at a certain time providing you with more “prep time” to get there in time which can especially help if you have a disability that slows you down on your way to the restroom.

Medications – Medication is mostly used for incontinence in combination with various habit exercises, they may include one of the following:

  • Detrol
  • Detrol LA
  • Ditropan
  • Ditropan XL
  • Enablex
  • Gelnique Gel
  • Oxytrol transdermal patch
  • Sanctura
  • Tofranil
  • Toviaz
  • Vesicare

Catheters – This involves inserting a small tube into the urethra (the tube in which urine exits the body) and into the bladder to allow an individual to void directly into a catheter bag. There are various types of catheters but typically you are going to insert and remove this every time you feel your bladder is full or there are some that can be worn under your clothing to allow you to void as needed.

6 thoughts on “Bladder Incontinence, Urgency, Retention, Nocturia & Hesitation

  • February 22, 2013 at 8:40 pm

    GREAT piece, Matt. But ooooh, that Hobbit Training can be a very risky business, or is it just me pushing the boundaries TOO FAR.

  • May 9, 2013 at 12:39 pm

    Do you know if the medication which treats female incontinence for MS can be used on males also?

  • May 9, 2013 at 1:18 pm

    Well which medication in particular? I would imagine it does, the bladder is not really different in males and females.


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