In an informative blog post recently published by the Rocky Mountain MS Center, multiple sclerosis medical practitioners address the issue of neurogenic bladder dysfunction that many MS patients experience, particularly as the disease progresses into later stages, such as secondary progressive MS. The blog post points out that, for anyone with bladder issues, the inability to either pass or hold urine often contributes to coping behavior patterns that often lead to a loss of quality of life. For example, multiple sclerosis patients may avoid long-distance travel, exercises such as walking or hiking (which are critically important for MS patients seeking to maintain their health as much as possible), and other social functions may be avoided for fear that bladder issues could lead to an embarrassing or emergency situation.
The issue is exacerbated in patients with multiple sclerosis, since bladder issues are the result of neurogenic bladder dysfunction, which is specifically the result of the breakdown of nerves and atrophy associated with the brain as a result of progressive MS. The result is a loss of voluntary urinary function; the patient simply does not have the ability to detect or control the need to void as a healthy person can.
Typically, neurogenic bladder dysfunction in other diseases and conditions, such as spinal cord injury or spin bifida, leave patients with options that involve the use of catheters, stomas, or urine bags, which in and of themselves lead to a new set of uncomfortable, life-altering conditions.
However, the Rocky Mountain MS Center believes that, in the case of multiple sclerosis patients, there is the need for the development of best practices for dealing with MS-related bladder issues, which involve a broad spectrum of different approaches for effectively mitigating the issues with minimal impact to quality of life.
The new project is being led by Dr. Augusto Miravalle, a neuro-immunologist at the Rocky Mountain MS Center at Anschutz Medical Campus, who is seeking to develop a systematic, universal approach to diagnose and assess neurogenic bladder in multiple sclerosis patients. “Patients often do not seek medical attention for this specific problem, as they may be too embarrassed,” Dr. Miravalle said. “Equally, health care providers often fail to discuss urinary symptoms as well. We have the opportunity to monitor a patient’s health just by having them answer a few validated questions, which is very exciting.”
Dr. Miravalle has already put this new effort into motion. He recently launched the program, which involves “screening multiple sclerosis patients with bladder issues, treating them, and collecting self-reported questionnaires to determine their health-related quality of life. From this study, he hopes to improve health care outcomes for all MS patients—and make talking about bladder issues a normalized part of care.” Both Dr. Miravalle and the Rocky Mountain MS Center at Anschutz Medical Campus believe that self-reported questionnaires from patients can in turn lead to new best practices for improved patient self-care and physician treatment of neurogenic bladder issues associated with multiple sclerosis.
Visit the Rocky Mountain MS Center for more information on this issue.