MULTIPLE SCLEROSIS-BLADDER DYSFUNCTION MGM

SUMMARY

1. General measures: fluid restriction, avoid fluids at night, timed toileting, pelvic floor exercises.

2. Clean intermittent self-catheterization

3. UTI should be ruled out and treated promptly.

4. Early symptoms of urgency and detrusor spasm can be blunted by oxybutynin or tolterodine.

5. Intermittent catheterization is recommended for patients with failure to empty. Ensure the patient has good cognition & hand function.

6. Night-time bladder dysfunction can be treated with low-dose Desmopressin.

7. Intravesical botulinum toxin injection is useful for severe detrusor hyperreflexia.

8. Periodic urodynamic studies should be considered as the pattern may change through the disease course.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].