Urinary symptoms are experienced by nearly all MSA patients and can be one of the earliest signs of the disease. Symptoms include trouble voiding, incontinence, increased frequency and urgency and leakage. In MSA, urinary tract problems are thought to occur due to a decline of neuronal control from the cerebellum. These problems can lead to a lack of control of the urinary sphincter and a change in activity of the detrusor muscle found in the wall of the bladder, leading to incontinence and an inability to fully empty the bladder. These problems can lead to repeated urinary tract infections and kidney infection if not properly treated.
1. Non-pharmacologic treatments of neurogenic bladder include:
A bladder diary is an important way to discern symptoms and the progression of symptoms in MSA patients. A bladder diary can track urinary tract symptoms, fluid intake, urine output, and time to voids.
2. Medications used to control neurogenic bladder include: