Oxybutynin is in a class of medications called anticholinergics/antimuscarinics. It is used in MS to treat overactive bladder, in which the bladder muscles contract uncontrollably to cause urinary urgency, frequency, and incontinence. Oxybutynin works by relaxing the bladder muscles to prevent contractions.
Medication
DDAVP nasal spray (desmopressin) is used to reduce frequent nighttime urination. Detrol (tolterodine) treats overactive bladder by relaxing the bladder muscles and preventing contractions. Ditropan (oxybutynin) treats overactive bladder by relaxing the bladder muscles and preventing contractions.
Bladder symptoms can usually be managed successfully with lifestyle modifications, medications, physical therapy and/or nerve stimulation procedures. diet modifications, adequate fluid intake up to a few hours before bedtime, bladder training or planned voiding, among others.
Holding a small, soft ball between your knees (about 10 to 16 inches apart), squeeze the ball with your legs while pulling your pelvic floor muscles up and in (doing a Kegel). Hold for 3 seconds, then relax for 3 seconds. Repeat 5 to 10 times, working up to 20 to 25 repetitions at a time.
Catheterization: In this treatment, patients are taught how to self-insert a small catheter tube in order to empty the bladder at regular intervals. Sacral Neuromodulation: In this relatively new approach, small electrodes and a stimulator are inserted near nerves related to bladder function.
Medications that relax the bladder can be helpful for relieving symptoms of overactive bladder and reducing episodes of urge incontinence. These drugs include: Tolterodine (Detrol) Oxybutynin, which can be taken as a pill (Ditropan XL) or used as a skin patch (Oxytrol) or gel (Gelnique)
Clean intermittent self-catheterization is the first-line recommended therapy for incomplete bladder emptying or urinary retention due to neurogenic bladder disorders. Patients unable to perform self-catheterization will need alternate therapy, such as an indwelling catheter.
Drugs: Medications that treat neurogenic bladder include oxybutynin, tolterodine, mirabegron, solifenacin succinate and others. Injections of botulinum A toxin (Botox®): Your healthcare provider injects botulinum A toxin into your bladder or urinary sphincters.
Medical Treatments
OAB drugs: These can help to relax overactive bladder muscles. These may be taken by mouth, or delivered through the skin with a gel or a patch. Catheters: This is often a treatment used for underactive bladder. This small tube is inserted into your urethra to help your bladder empty fully.
“There are several lifestyle changes, including bladder retraining techniques, dietary changes, avoiding bladder irritants, pelvic floor exercises and pelvic floor physical therapy that can help tremendously. If those fail to provide you relief, there are non-surgical and surgical options that we can offer.”
Urispas contains an anti-spasmodic which works by inhibiting bladder contractions in the urinary tract in addition to reducing associated pain. Urispas is used to treat muscle spasms of the urinary tract which may be a result of inflammation of the bladder, prostate gland or urethra.
"Unfortunately, urinary incontinence isn't likely to go away on its own. The good news, however, is that there are things that you can do on your own to improve it, and there are plenty of options for treating it," adds Dr. Lindo.
Treatment Overview. Several types of behavioural methods are used for treating urinary incontinence: bladder training, habit training, biofeedback, and pelvic muscle exercises. People who have incontinence due to physical or mental limitations (functional incontinence) can try timed voiding and prompted voiding.
Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection (UTI). Once treated, frequent urination and leakage problems caused by a UTI typically end.
Bladder training and pelvic floor exercises are just two natural treatments for overactive bladder. Research suggests that these nondrug remedies can be very effective for many women, and they have almost no side effects.
There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence. Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
NEUROGENIC BLADDER DYSFUNCTION IN MS
The demyelination of MS interferes with signals between the bladder, the spinal cord, and brain, causing urination to become less controlled. Dysfunction may occur in the detrusor, external sphincter, or in the coordination of their functions.
The pons is a major relay center between the brain and the bladder. The mechanical process of urination is coordinated by the pons in the area known as the pontine micturition center (PMC). The conscious sensations associated with bladder activity are transmitted to the pons from the cerebral cortex.
In overactive bladder (often seen with strokes, brain disease and Parkinson's disease), the muscles squeeze more often than normal. Sometimes this squeezing causes urine to leak before you're ready to go to the bathroom (incontinence).