A to Z of MS Urinary tract infection (UTI)

Urinary tract infections (UTIs) are sometimes referred to by the general term cystitis, although cystitis is in fact just one type of UTI.

UTIs are common in multiple sclerosis, partly because of the high proportion of people who experience bladder problems. However, they are also relatively common in the general population.

Symptoms include:

• frequent urge to urinate
• painful or burning sensation when urinating
• feeling generally tired or washed out most of the time
• painful bladder or abdomen even when not urinating
• passing a small amount of urine when urinating, even though there is an urge to pass more
• milky or cloudy urine that may smell more strongly than usual

Most people experience some or all of these symptoms if they have a UTI.

These symptoms can be confused with other MS symptoms such as fatigue or existing bladder problems. However, it is important to check for a UTI if someone is feeling generally unwell or experiences a worsening of existing symptoms, as UTIs are straightforward to treat. Untreated UTIs can lead to worsening spasticity, kidney damage and may trigger a relapse.

Treatment of urinary tract infections is a two-stage process that can be carried out by a GP:

• dipstick test to check for urinary tract infection. Sometimes these may need to be sent to a lab for analysis to determine the type of bacteria causing the infection
• treatment with appropriate antibiotics

UTIs normally respond well to antibiotics and clear up in a few days.

Common causes of UTIs in MS can include stagnant urine due to urinary retention or introducing infection through poor personal hygiene.

The NICE Guideline recommends that anyone experiencing more than three UTIs a year should be assessed by a continence specialist for risk factors and offered appropriate treatment and guidance. GPs should be able to make a referral. The NICE Guideline does not recommend using antibiotics or cranberry juice prophylactically, that is, on a regular basis to guard against infection.

Reference

Fowler CJ, et al.
A UK consensus on the management of the bladder in multiple sclerosis.
Journal of Neurology Neurosurgery and Psychiatry 2009;80(5):470-477.
abstract

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