Managing urinary tract infections in multiple sclerosis – can we do better?

Bladder infections in MS; what can we do about them? #MSBlog #MSResearch

Bladder dysfunction is common in MS. Around 50-90% of MSers will develop overactive bladder, which can lead to incomplete emptying of the bladder and in severe cases, retention of urine. Some MSers will need to use urinary catheters to empty their bladder, which together with stasis of urine leaves MSers susceptible to recurrent urinary tract infections (UTIs).

Infection, particularly recurrent infection can influence progression of disease in multiple sclerosis. We know that around the time of an infection, MSers are at greater risk of developing a relapse. Not only this, relapses can be more severe and of longer duration in the context of infection. Having more relapses, particularly in the early stages of multiple sclerosis may lead to worse long term outcomes.

Despite this, management of these infections particularly of UTIs remains an area for improvement. Recent data has shown that the most common cause of hospital admission in MSers is due to UTI. So what can we do to improve?

In other conditions such as chronic obstructive pulmonary disease (a condition affecting the lungs leading to progressive shortness of breath and often recurrent chest infections), community teams have worked together in order to ensure early treatment of chest infections. Patients are taught how to recognize early signs of infection. They are provided with rescue pack antibiotics and are encouraged to take these should they suspect infection. This has been shown to reduce rates of hospital admission and have a positive effect of quality of life.

Could this model be applied to UTI treatment in MS? 

Do you think that a self management tool could help MSers confidently recognize signs of early infection and initiate treatment independently at home in order to prevent subsequent relapses, hospital admission and ultimately disease progression?

Please take a few minutes to answer my short survey.

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