Posted by: Thixia | April 4, 2008

Urinary Dysfunction and MS 1 of 7

  Urinary Dysfunction and MS  A Guide for People with Multiple Sclerosis Introduction 

Normal bladder function is important not only for a person’s overall health, but also for feelings of comfort and self-esteem.  Fortunately, advances in bladder management strategies are making it possible for people with MS to carry out their daily activities at home and at work with confidence – secure in the knowledge that they have their bladder function under control.  These same advances have significantly decreased the incidence of bladder complications and the number of MS-related hospitalizations.  

  • In order to achieve confidence and control, it is important to understand:
  • How the normal bladder functions
  • The changes that can occur in MS to interfere with normal bladder function
  • The available treatments and management strategies to regain and/or maintain bladder comfort and control, and prevent unnecessary complications

This Guide is designed to help you be an informed partner in your MS care.  Keep in mind, however, that no two people with MS are exactly alike, and that health-care providers may differ somewhat in their management of MS urinary symptoms.  

Members of your health-care team can obtain a free copy of Urinary Dysfunction and Multiple Sclerosis, the clinical practice guideline written for professionals, by logging onto the website of the Paralyzed Veterans of America at http://www.pva.org.  They may also be interested in the resource, Talking With Your MS Patients about Difficult Subjects, which includes a publication on elimination problems, available on the MS Society of Canada website at http://www.mssociety.ca.  

Normal bladder function 

The purpose of the urinary system is to remove waste products from the blood and eliminate them from the body.  When the urinary system is functioning normally, the process of urination feels natural and controlled.  Urine collects slowly in the bladder, causing it to expand.  Once the bladder has accumulated 113 mls to 227 mls of urine, nerve endings in the bladder transmit signals to the spinal cord which, in turn, transmits signals to the brain that voiding needs to occur.  The person experiences the need to urinate and makes a decision when and where to do so.  As the person prepares to urinate, the brain relays a return signal to the spinal cord that triggers the voiding reflex.  The voiding reflex causes two things to happen simultaneously: 

  1. The detrusor muscle contracts to expel the urine from the bladder. 
  2. The external sphincter relaxes and opens to allow the urine to pass freely into the urethra and out of the body.  

Urinary System Components 

  • KIDNEYS – the organs that extract impurities and water from the blood to produce urine
  • URETERS – thin tubes that carry urine from the kidneys to the bladder
  • BLADDER – an elastic sac that stores the urine prior to voiding (urination)
  • DETRUSOR MUSCLE – the muscular portion of the bladder that contracts to expel urine from the bladder into the urethra and out of the body
  • EXTERNAL SPHINCTER – a circular band of muscle fibres, located just below the juncture between the bladder and the urethra, which remains closed between times of urination
  • URETHRA – the tube that carries the urine from the bladder, through the meatus, to the outside of the body
  • MEATUS – the external opening of the urethra in both women and men

Compliments of:

Multiple Sclerosis Society of Canada

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