Common symptoms of multiple sclerosis (MS) include an increase in the urge and frequency to urinate. If left untreated, this can lead to complications like urinary tract infections (UTIs) and kidney stones.

MS is a chronic (long-term) condition that affects the central nervous system. It causes the immune system to attack and damage myelin, the protective material surrounding nerve cells.

MS may lead to a wide range of symptoms that may affect the function of your vision, muscles, immune system, cognition, and bladder, among others.

According to the National Multiple Sclerosis Society, at least 8 out of 10 people with MS experience some type of bladder dysfunction.

Keep reading to learn more about how MS may affect your bladder and kidney function and how to manage it.

Bladder dysfunction is a relatively common occurrence in MS. Bladder issues aren’t always constant, but they may flare up and, in some cases, lead to kidney damage.

Bladder issues can develop with MS due to damage or dysfunction to the nerves signaling bladder contraction. This may lead to issues with how the bladder stores urine or how it empties urine.

Bladder storage issues

Bladder storage dysfunction is a symptom of an overactive bladder, meaning that nerve damage within your body can cause your bladder muscle to contract more often than it should.

The most common symptoms of an overactive bladder are an increased urge and frequency to urinate, which are due to these spastic contractions.

Some research suggests that more than 7 in 10 people with MS experience frequency issues, while 6 in 10 people experience urgency issues.

Symptoms of overactive bladder may include:

  • a strong urge to urinate
  • frequent need to use the bathroom
  • the need to get up several times at night to urinate
  • incontinence (an inability to control urination)

Bladder emptying issues

Bladder emptying problems mean your bladder doesn’t empty completely when you urinate. It happens when nerve damage interferes with the signal that tells your bladder to void, causing your bladder to never completely empty.

Bladder emptying issues affect around 6 in 10 people with MS.

Symptoms of an emptying dysfunction may include:

  • hesitancy when you try to urinate
  • weak urinary stream
  • incontinence
  • urinary tract infections (UTIs)

Combined storage and emptying issues

It’s possible to have both bladder emptying and storage dysfunctions. This occurs when nerve damage causes the muscles in your bladder and urinary sphincter to fail to coordinate properly.

Symptoms can include all those associated with emptying and storage problems.

Does MS cause dark urine?

Dark urine may be a symptom of several health conditions, including dehydration and medical conditions that affect the kidneys and liver.

If you have MS and experience dark urine, it may be a symptom of dehydration, UTI, or a kidney infection.

Speak with a healthcare professional if dark urine doesn’t improve after drinking water. They can provide a proper diagnosis and develop a treatment plan for you.

A bladder emptying dysfunction can lead to a urinary tract infection (UTI). When your bladder doesn’t fully empty, your risk of developing a UTI increases because the urine left over in your bladder allows bacteria to grow.

UTIs associated with MS are likely to come back, especially if you don’t get treatment for the emptying dysfunction.

Symptoms of a UTI may include:

  • an urgent need to urinate
  • frequent urination
  • urinating more often at night
  • burning sensation when you urinate
  • cloudy, dark, or smelly urine
  • pain in your lower back or lower abdomen
  • fever

In rare cases, bladder dysfunctions associated with MS may lead to kidney problems, especially if an emptying dysfunction or a UTI is left untreated for a long time.

The most common kidney complications are kidney stones and infections. If left untreated, kidney infections may spread to other parts of the body and lead to urosepsis, which is a life threatening complication.

Some treatments used to manage symptoms of MS may also lead to kidney complications.

A 2022 review found that the most commonly reported kidney condition related to MS is glomerulonephritis. Disease-modifying therapies (DMTs) like beta interferons usually cause it.

Other rare kidney complications associated with MS may include thrombotic microangiopathy and kidney failure.

It’s important to speak with a healthcare professional if you experience any infection symptoms, including UTI.

Social support for MS and bladder issues

If you find it difficult to speak with a doctor about bladder problems, you’re not alone.

Having this talk may bring up feelings of embarrassment, but it’s important that you do, as they could help develop a treatment plan for you.

Similarly, having an overactive bladder or incontinence may cause anxiety, especially in social situations. Consider speaking with your friends and family about how you’re feeling and what you’re experiencing.

This way, they could better understand what you need and help choose activities and locations that may be better for you, such as having easy access to a bathroom.

Treatment for bladder dysfunction and kidney issues related to MS depends on the underlying cause. A doctor can help develop the best treatment plan for you, which may include lifestyle and medical treatments.

Lifestyle treatments

The following lifestyle and dietary strategies may help you manage symptoms of an overactive bladder:

  • schedule bathroom breaks throughout the day
  • avoid bladder irritants, such as alcohol, cigarettes, and caffeine
  • stop drinking fluids 2 hours before bed
  • keep an extra pair of clothes at work or in your car
  • try pelvic floor exercises
  • try bladder training specifically for males or females

If you have trouble emptying your bladder completely, wait several minutes after urinating and then try again. Consider using pads for incontinence or times when you know you won’t be able to get to a bathroom immediately.

Treatment for kidney stones depends on their size. If they’re relatively small, a doctor may recommend the following to help the stones pass through urine:

  • drinking plenty of fluids
  • reducing your salt intake
  • exercising

Medical treatments for bladder dysfunction

If lifestyle strategies don’t help relieve bladder dysfunction symptoms, a doctor may prescribe medication to control bladder contractions and reduce the urge to urinate.

For a bladder storage issue, a doctor may recommend:

For an emptying dysfunction, a doctor may recommend an intermittent catheterization. This involves inserting a thin tube into your bladder to drain excess urine.

For a UTI, a doctor will prescribe antibiotics to help kill the bacteria.

Medical treatments for kidney problems

Research suggests that 86% of small kidney stones will pass through on their own within 30 to 40 days.

However, you may require surgery to help break down larger stones that cannot pass on their own or if you have complications like kidney infection or kidney failure.

Surgery for kidney stones may include:

A doctor can help you decide which option is the best for you.

If you have a kidney infection, antibiotic treatment is needed.

Untreated infections and kidney stones may be painful and cause serious kidney complications if left untreated.

Bladder issues related to MS are common and treatable. Although they may be difficult to bring up with a doctor, they can lead to serious issues with your kidneys if left untreated.

A doctor can help develop a treatment plan that includes lifestyle, dietary, and medical interventions to help manage bladder- and kidney-related issues with MS.