Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer  

Question: Are urinary tract infections (UTIs) more common in MS, and what are the symptoms and treatments?

Answer: Yes, urinary tract infections are more common in people with MS. Multiple sclerosis is often associated with bladder dysfunction and bladder dysfunction is often associated with urinary tract infections. The most common bladder problem associated with infections is urinary retention, which is incomplete emptying of the bladder. This creates an ideal incubator for bacteria to grow. Patients who catheterize may also be at an increased risk, particularly if not careful with their bladder technique.

Classical symptoms of urinary tract infections are urgency, frequency, burning when urinating, and fever. But people with multiple sclerosis may not have typical symptoms, particularly because they may already have urgency and frequency of urination without an infection. Additionally, people with MS may experience a worsening of their MS symptoms when they have a urinary tract infection, a condition referred to as a pseudoexacerbation, since it may look and feel like an acute attack.

Urinary tract infections should be taken seriously. They can cause worsening MS function, including spasticity. They are associated with an increase in the likelihood of hospitalizations. Most urinary tract infections can be treated with a broad-spectrum antibiotic. If urinary tract infections are frequent, it may be appropriate to get a referral to a specialist such as a urologist. They may advise other medications, different catheter techniques, and/or pelvic floor exercises. They may also advise specialized interventions, devices, or Botox injections. 

For the prevention of urinary tract infections, common sense habits – including good hydration, attention to bladder emptying, and improved wiping techniques – should be utilized. Urinary tract infections may be more common in multiple sclerosis, but they are not inevitable!

Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.

MSAA’s Ask the Expert series received a Merit Award from the 26th Annual Digital Health Awards!