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Management of Bladder and Bowel Dysfunction in Patients with Multiple Sclerosis

Year 2024, Volume: 14 Issue: 3, 445 - 450, 19.09.2024
https://doi.org/10.33631/sabd.1322567

Abstract

Bladder and bowel dysfunctions are common in patients with multiple sclerosis (MS) and negatively affect their quality of life. Bladder dysfunction, which is prevalent in people with MS (PwMS), can impact almost all patients within 10 years after diagnosis. Conservative, medical, and electrical stimulation approaches are used in the treatment of these problems. Bladder dysfunction in patients with multiple sclerosis can lead to issues such as fluid intake restriction, withdrawal from work life, inability to socialize, and the need for constant use of pads, resulting in a depressive lifestyle. Bowel dysfunction in patients with multiple sclerosis can manifest as fecal incontinence and/or constipation, which can also negatively affect patients' quality of life. Various approaches are utilized in the management of bladder and bowel dysfunction. Multiple sclerosis nurses play a key role in the multidisciplinary team for the diagnosis, treatment, and follow-up of patients' bladder and bowel symptoms. Effective nursing care, education, and counseling in the management of these symptoms enhance the comfort of patients with multiple sclerosis. In this review, the bladder and bowel dysfunctions experienced by patients with multiple sclerosis and the management of these problems are discussed in line with current knowledge.

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References

  • Frischer JM, Weigand SD, Guo Y, Kale N, Parisi JE, Pirko I, et al. Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaques. Annals of neurology. 2015; 78(5): 710-21.
  • Bölük C, Türk Börü Ü, Taşdemir M, Gezer T. Epidemiology of multiple sclerosis in Turkey; a ten-year trend in rural cities. Turk J Neurol. 2021; 27(1): 41-5.
  • Nazari F, Shaygannejad V, Mohammadi Sichani M, Mansourian M, Hajhashemi V. The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis. BMC Neurol. 2020; 20(1): 24.
  • Panicker JN, Sakakibara R. Lower urinary tract and bowel dysfunction in neurologic disease. Continuum: Lifelong Learning in Neurology. 2020; 26(1): 178-99.
  • Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci. 2008; 9(6): 453-66.
  • Villalba Bachur Roberto F, Kohan Diego F, Fernandez C Gaston, Angeloni Guido, Koren Claudio A, Longo Emilio M. Botulinum toxin type A in neurogenic overactive bladder dysfuction in patients with multiple sclerosis. Urol Androl Open J. 2021; 5(1): 10-4.
  • Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An international urogynecological association (iuga) / international continence society (ics) joint report on the terminology for female pelvic organ prolapse (pop). Int Urogynecol J. 2016; 27(2): 165-94.
  • Seddone S, Marturano M, Bientinesi R, Lucchini M, Bassi P, Mirabella M, et al. Lower urinary tract disorders in multiple sclerosis patients: prevalence, clinical features, and response to treatments. Neurourology and Urodynamics. 2021; 40(6): 1500-8.
  • Lakin L, Davis BE, Binns CC, Currie KM, Rensel MR. A comprehensive approach to the management of multiple sclerosis: addressing invisible symptoms—a narrative review. Neurology and therapy. 2021; 10: 75-98.
  • Polat Dunya C, Tulek Z, Kürtüncü M, Panicker JN, Eraksoy M. Effectiveness of transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder. Multiple Sclerosis Journal. 2021; 27(4): 621-9.
  • UrologyCareFoundation.org [Internet]. USA; American Urological Association. Overactive Bladder Diary. [Updated:2021; Cited:2023 March 20]. Available from: https://www.urologyhealth.org/resources/Bladder-Diary.
  • Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. J Exerc Rehabil. 2021; 17(6): 379-87.
  • Shah A, Panchal V, Patel K. Pathogenesis and management of multiple sclerosis revisited. Disease-a-Month. 2022; 69(9): 101497.
  • Tobin WO. Management of multiple sclerosis symptoms and comorbidities. Continuum (Minneap Minn). 2019; 25(3): 753-72.
  • Sparaco M, Bonavita S. Pelvic floor dysfunctions and their rehabilitation in multiple sclerosis. Journal of Clinical Medicine. 2022; 11(7): 1941.
  • Burton CS, Korsandi S, Enemchukwu E. Current state of non-surgical devices for female stress urinary incontinence. Current Urology Reports. 2022; 23(9): 185-94.
  • Grgar L. Prevention of catheter-related urinary tract infections: the octenidine hypothesis. Medical Hypotheses. 2020; 137: 109561.
  • Gray M, Wasner M, Nichols T. Nursing practice related to intermittent catheterization: a cross-sectional survey. Journal of the wound, ostomy, and continence nursing: official publication of The Wound, Ostomy, and Continence Nurses Society. 2019; 46(5): 418-23.
  • Corona LE, Sion NR, Cameron AP, Barboglio Romo PG, Stoffel JT. Intermittent catheterization and urinary tract infection in multiple sclerosis patients. Can J Urol. 2020; 27(4): 10294-9.
  • Zonic-Imamovic M, Imamovic S, Cickusic A, Delalic A, Hodzic R, Imamovic M. Effects of treating an overactive urinary bladder in patients with multiple sclerosis. Acta medica academica. 2019; 48(3): 271-7.
  • Rahnama’I MS. Neuromodulation for functional bladder disorders in patients with multiple sclerosis. Multiple Sclerosis Journal. 2020; 26(11): 1274-80.
  • Bhide AA, Tailor V, Fernando R, Khullar V, Digesu GA. Posterior tibial nerve stimulation for overactive bladder—techniques, and efficacy. International urogynecology journal. 2020; 31(5): 865-70.
  • Teoli D, An J. Transcutaneous electrical nerve stimulation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
  • Canbaz Kabay S, Kabay S, Mestan E, Cetiner M, Ayas S, Sevim M, et al. Long-term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12‐months results. Neurourology and urodynamics. 2017; 36(1): 104-10.
  • De Seze M, Raibaut P, Gallien P, Even‐Schneider A, Denys P, Bonniaud V, et al. Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourology and urodynamics. 2011; 30(3): 306-11.
  • Díaz-Ruiz MDC, Romero-Galisteo RP, Arranz-Martín B, Palomo-Carrión R, Ando-Lafuente S, Lirio-Romero C. Vibration or transcutaneous tibial nerve stimulation as a treatment for sexual dysfunction in women with spinal cord injury: study protocol for a randomized clinical trial. International Journal of Environmental Research and Public Health. 2022; 19(3): 1478.
  • Uzunköprü C. Invasive therapies in multiple sclerosis. Archives of Neuropsychiatry. 2018; 55(Suppl 1), S21.
  • Fontaine C, Papworth E, Pascoe J, Hashim H. Update on the management of overactive bladder. Therapeutic Advances in Urology. 2021; 13: 17562872211039034.
  • Andretta E, Simeone C, Ostardo E, Pastorello M, & Zuliani C. Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction. Journal of the Neurological Sciences. 2014; 347(1-2): 257-61.
  • Miget G, Tan E, Pericolini M, Chesnel C, Haddad R, Turmel N, et al. The neurogenic bowel dysfunction score (nbd) is not suitable for patients with multiple sclerosis. The spinal cord. 2022; 60(12): 1130-5.
  • D’Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H, et al. The International Continence Society (ICS) reports on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol. Urodyn. 2019; 38: 433-77.
  • Johns JS, Krogh K, Ethans K, Chi J, Querée M, Eng JJ, et al. Pharmacological management of neurogenic bowel dysfunction after spinal cord injury and multiple sclerosis: a systematic review and clinical implications. Journal of Clinical Medicine. 2021; 10(4): 882.
  • Emmanuel A. Neurogenic bowel dysfunction [version 1; peer review: 2 approved] F1000Research 2019, 8(F1000Faculty Rev):1800.
  • Bharucha AE, Knowles CH, Mack I. Fecal incontinence in adults. Nature Reviews Disease Primers. 2022; 8(1): 53.
  • Gulick EE. Neurogenic bowel dysfunction over the course of multiple sclerosis: a review. International Journal of MS Care. 2022; 24(5): 209-17.
  • Rodriguez GM, Gater DR. Neurogenic bowel and management after spinal cord injury: a narrative review. J Pers Med. 2022; 12(7): 1141.
  • Brown HW, Dyer KY, Rogers RG. Management of fecal incontinence. Obstetrics & Gynecology. 2020; 136(4): 811-22.
  • Teng M, Miget G, Moutounaïck M. Transanal irrigation for neurogenic bowel dysfunction in multiple sclerosis: a retrospective study. Journal of neurogastroenterology and motility. 2022; 28(2): 320-6.
  • Dehghan M, Malakoutikhah A, Heidari FG, Zakeri MA. The effect of abdominal massage on gastrointestinal functions: a systematic review. Complementary therapies in medicine. 2020; 54: 102553.
  • McClurg D, Hagen S, Hawkins S, & Lowe-Strong A. Abdominal massage for the alleviation of constipation symptoms in people with multiple sclerosis: a randomized controlled feasibility study. Multiple Sclerosis Journal. 2011; 17(2): 223-33.

Multipl Sklerozlu Hastalarda Mesane ve Bağırsak Disfonksiyonunun Yönetimi

Year 2024, Volume: 14 Issue: 3, 445 - 450, 19.09.2024
https://doi.org/10.33631/sabd.1322567

Abstract

Multipl sklerozlu hastalarda mesane ve bağırsak disfonksiyonları sık görülür ve yaşam kalitelerini olumsuz etkiler. Multiple skleroz hastalarında sık görülen ve yaşam kalitelerini etkileyen mesane disfonksiyonu, tanı konulduktan 10 yıl sonra hemen hemen tüm hastaları etkileyebilmektedir. Bu sorunların tedavisinde konservatif, medikal, elektriksel uyarı gibi yaklaşımlar kullanılmaktadır. Multipl sklerozlu hastalarda mesane disfonksiyonu sıvı alımının kısıtlanması, iş hayatından çekilme, sosyalleşememe ve sürekli ped kullanma ihtiyacı gibi sorunlara yol açarak depresif bir yaşantıya neden olabilir. Multipl sklerozlu hastalarda bağırsak disfonksiyonu fekal inkontinans ve/veya konstipasyon şeklinde görülebilmekte ve hastaların yaşam kalitelerini olumsuz yönde etkilyebilmektedir. Mesane ve bağırsak disfonksiyonu yönetiminde çeşitli yaklaşımlar kullanılmaktadır. Multipl skleroz hemşireleri hastaların mesane ve bağırsak semptomlarının tanı, tedavi ve takibinde multidisipliner ekipte anahtar role sahiptir. Bu semptomların yönetiminde etkili hemşirelik bakımı, eğitim ve danışmanlık verilmesi multipl sklerozlu hastaların yaşam kalitelerini arttırmaktadır. Bu derlemede multipl sklerozlu hastaların yaşadığı mesane ve bağırsak disfonksiyonları ve bu problemlerin yönetimi güncel bilgiler doğrultusunda tartışılmıştır.

Project Number

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References

  • Frischer JM, Weigand SD, Guo Y, Kale N, Parisi JE, Pirko I, et al. Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaques. Annals of neurology. 2015; 78(5): 710-21.
  • Bölük C, Türk Börü Ü, Taşdemir M, Gezer T. Epidemiology of multiple sclerosis in Turkey; a ten-year trend in rural cities. Turk J Neurol. 2021; 27(1): 41-5.
  • Nazari F, Shaygannejad V, Mohammadi Sichani M, Mansourian M, Hajhashemi V. The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis. BMC Neurol. 2020; 20(1): 24.
  • Panicker JN, Sakakibara R. Lower urinary tract and bowel dysfunction in neurologic disease. Continuum: Lifelong Learning in Neurology. 2020; 26(1): 178-99.
  • Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci. 2008; 9(6): 453-66.
  • Villalba Bachur Roberto F, Kohan Diego F, Fernandez C Gaston, Angeloni Guido, Koren Claudio A, Longo Emilio M. Botulinum toxin type A in neurogenic overactive bladder dysfuction in patients with multiple sclerosis. Urol Androl Open J. 2021; 5(1): 10-4.
  • Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An international urogynecological association (iuga) / international continence society (ics) joint report on the terminology for female pelvic organ prolapse (pop). Int Urogynecol J. 2016; 27(2): 165-94.
  • Seddone S, Marturano M, Bientinesi R, Lucchini M, Bassi P, Mirabella M, et al. Lower urinary tract disorders in multiple sclerosis patients: prevalence, clinical features, and response to treatments. Neurourology and Urodynamics. 2021; 40(6): 1500-8.
  • Lakin L, Davis BE, Binns CC, Currie KM, Rensel MR. A comprehensive approach to the management of multiple sclerosis: addressing invisible symptoms—a narrative review. Neurology and therapy. 2021; 10: 75-98.
  • Polat Dunya C, Tulek Z, Kürtüncü M, Panicker JN, Eraksoy M. Effectiveness of transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder. Multiple Sclerosis Journal. 2021; 27(4): 621-9.
  • UrologyCareFoundation.org [Internet]. USA; American Urological Association. Overactive Bladder Diary. [Updated:2021; Cited:2023 March 20]. Available from: https://www.urologyhealth.org/resources/Bladder-Diary.
  • Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. J Exerc Rehabil. 2021; 17(6): 379-87.
  • Shah A, Panchal V, Patel K. Pathogenesis and management of multiple sclerosis revisited. Disease-a-Month. 2022; 69(9): 101497.
  • Tobin WO. Management of multiple sclerosis symptoms and comorbidities. Continuum (Minneap Minn). 2019; 25(3): 753-72.
  • Sparaco M, Bonavita S. Pelvic floor dysfunctions and their rehabilitation in multiple sclerosis. Journal of Clinical Medicine. 2022; 11(7): 1941.
  • Burton CS, Korsandi S, Enemchukwu E. Current state of non-surgical devices for female stress urinary incontinence. Current Urology Reports. 2022; 23(9): 185-94.
  • Grgar L. Prevention of catheter-related urinary tract infections: the octenidine hypothesis. Medical Hypotheses. 2020; 137: 109561.
  • Gray M, Wasner M, Nichols T. Nursing practice related to intermittent catheterization: a cross-sectional survey. Journal of the wound, ostomy, and continence nursing: official publication of The Wound, Ostomy, and Continence Nurses Society. 2019; 46(5): 418-23.
  • Corona LE, Sion NR, Cameron AP, Barboglio Romo PG, Stoffel JT. Intermittent catheterization and urinary tract infection in multiple sclerosis patients. Can J Urol. 2020; 27(4): 10294-9.
  • Zonic-Imamovic M, Imamovic S, Cickusic A, Delalic A, Hodzic R, Imamovic M. Effects of treating an overactive urinary bladder in patients with multiple sclerosis. Acta medica academica. 2019; 48(3): 271-7.
  • Rahnama’I MS. Neuromodulation for functional bladder disorders in patients with multiple sclerosis. Multiple Sclerosis Journal. 2020; 26(11): 1274-80.
  • Bhide AA, Tailor V, Fernando R, Khullar V, Digesu GA. Posterior tibial nerve stimulation for overactive bladder—techniques, and efficacy. International urogynecology journal. 2020; 31(5): 865-70.
  • Teoli D, An J. Transcutaneous electrical nerve stimulation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
  • Canbaz Kabay S, Kabay S, Mestan E, Cetiner M, Ayas S, Sevim M, et al. Long-term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12‐months results. Neurourology and urodynamics. 2017; 36(1): 104-10.
  • De Seze M, Raibaut P, Gallien P, Even‐Schneider A, Denys P, Bonniaud V, et al. Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourology and urodynamics. 2011; 30(3): 306-11.
  • Díaz-Ruiz MDC, Romero-Galisteo RP, Arranz-Martín B, Palomo-Carrión R, Ando-Lafuente S, Lirio-Romero C. Vibration or transcutaneous tibial nerve stimulation as a treatment for sexual dysfunction in women with spinal cord injury: study protocol for a randomized clinical trial. International Journal of Environmental Research and Public Health. 2022; 19(3): 1478.
  • Uzunköprü C. Invasive therapies in multiple sclerosis. Archives of Neuropsychiatry. 2018; 55(Suppl 1), S21.
  • Fontaine C, Papworth E, Pascoe J, Hashim H. Update on the management of overactive bladder. Therapeutic Advances in Urology. 2021; 13: 17562872211039034.
  • Andretta E, Simeone C, Ostardo E, Pastorello M, & Zuliani C. Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction. Journal of the Neurological Sciences. 2014; 347(1-2): 257-61.
  • Miget G, Tan E, Pericolini M, Chesnel C, Haddad R, Turmel N, et al. The neurogenic bowel dysfunction score (nbd) is not suitable for patients with multiple sclerosis. The spinal cord. 2022; 60(12): 1130-5.
  • D’Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H, et al. The International Continence Society (ICS) reports on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol. Urodyn. 2019; 38: 433-77.
  • Johns JS, Krogh K, Ethans K, Chi J, Querée M, Eng JJ, et al. Pharmacological management of neurogenic bowel dysfunction after spinal cord injury and multiple sclerosis: a systematic review and clinical implications. Journal of Clinical Medicine. 2021; 10(4): 882.
  • Emmanuel A. Neurogenic bowel dysfunction [version 1; peer review: 2 approved] F1000Research 2019, 8(F1000Faculty Rev):1800.
  • Bharucha AE, Knowles CH, Mack I. Fecal incontinence in adults. Nature Reviews Disease Primers. 2022; 8(1): 53.
  • Gulick EE. Neurogenic bowel dysfunction over the course of multiple sclerosis: a review. International Journal of MS Care. 2022; 24(5): 209-17.
  • Rodriguez GM, Gater DR. Neurogenic bowel and management after spinal cord injury: a narrative review. J Pers Med. 2022; 12(7): 1141.
  • Brown HW, Dyer KY, Rogers RG. Management of fecal incontinence. Obstetrics & Gynecology. 2020; 136(4): 811-22.
  • Teng M, Miget G, Moutounaïck M. Transanal irrigation for neurogenic bowel dysfunction in multiple sclerosis: a retrospective study. Journal of neurogastroenterology and motility. 2022; 28(2): 320-6.
  • Dehghan M, Malakoutikhah A, Heidari FG, Zakeri MA. The effect of abdominal massage on gastrointestinal functions: a systematic review. Complementary therapies in medicine. 2020; 54: 102553.
  • McClurg D, Hagen S, Hawkins S, & Lowe-Strong A. Abdominal massage for the alleviation of constipation symptoms in people with multiple sclerosis: a randomized controlled feasibility study. Multiple Sclerosis Journal. 2011; 17(2): 223-33.
There are 40 citations in total.

Details

Primary Language English
Subjects Nursing (Other)
Journal Section Reviews
Authors

Cansu Polat Dünya 0000-0002-3029-0446

Medine Yücesoy 0000-0003-2424-8708

Project Number -
Publication Date September 19, 2024
Submission Date July 4, 2023
Published in Issue Year 2024 Volume: 14 Issue: 3

Cite

Vancouver Polat Dünya C, Yücesoy M. Management of Bladder and Bowel Dysfunction in Patients with Multiple Sclerosis. VHS. 2024;14(3):445-50.