Bladder spasms

Bladder spasms are contractions of the bladder. They may be caused by a urinary tract infection (UTI) or irritation from a catheter. They may also occur in any disease that affects the nervous system, such as multiple sclerosis (MS). People who have had surgery in this area of the body might also have bladder spasms. Certain medicines such as the diuretic frusemide (Lasix), spicy and acidic foods, and drinks such as coffee may also cause them.
Bladder spasms can be painful and often lead to an urge to urinate. Incontinence may occur if the bladder spasms continue because the contractions will force urine out. If a catheter is in place, the spasm can occasionally force the drainage bag off the end of the catheter. Spasms may also make it difficult to remove a catheter (see ‘Catheter changes‘).

When Iain first had bladder spasms, he didn’t know what they were. He had bad pain in the abdomen…

Age at interview 35

Gender Male

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Roger had a spinal cord injury, his neurological problem made his bladder worse:

Roger said that he was always in some sort of pain, either mild or more serious. He took baclofen…

Age at interview 66

Gender Male

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Jade had Fowler’s Syndrome.

Jade’s bladder spasms sometimes forced the bag off the end of the catheter, particularly when she…

Age at interview 22

Gender Female

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Bladder spasms can be treated conservatively with pelvic floor exercises, and changes to fluid intake and diet, and often medicines. If these treatments don’t work, electrical stimulation through the skin (transcutaneous electrical nerve stimulation, ‘TENS’) might be used, sending mild electrical pulses to the bladder through patches applied to the skin.
In other cases, doctors may suggest a procedure called sacral nerve stimulation (also called sacral neuromodulation). A device is placed under the skin to deliver gentle electrical pulses to the bladder at regularly timed intervals. This may be used for severe bladder spasms and urge incontinence that does not respond to other treatments. It is not suitable for everyone. In rare cases, doctors may suggest surgery.

Jennifer describes what happened when she had sacral nerve stimulation.

Age at interview 26

Gender Female

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Complementary therapies include acupuncture, biofeedback (a method that teaches the mind to control normally automated body functions) and Botox (see below). Many people we interviewed talked about what had been prescribed to control bladder spasms.

To help control her bladder spasms, Jade’s consultant found a good combination of medicines,…

Age at interview 22

Gender Female

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Jennifer’s bladder spasms were well controlled with a combination of three medicines. Drinking…

Age at interview 26

Gender Female

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A few other medicines were mentioned too. For example, Frances, with multiple sclerosis, had used Sativex, a spray made from cannabis, to prevent bladder spasms. Before a medicine can be marketed in the UK, it must be licensed by either the European Medicines Agency (EMA) or the British Medicines and Healthcare products Regulatory Agency (MHRA). Sativex is licensed by the EMA, allowing specialists to prescribe it. Frances used the spray before the district nurse comes to change her catheter.
All medicines have side effects which may not be obvious. In some people oxybutynin caused a dry mouth. Jennifer found oxybutynin patches better than the tablets, but thought doctors might not tell people about them because they are expensive. Other people were not sure which of their medicines caused which side effects.

Frances, with MS, described the horrendous’ side effects of oxybutynin. It dried her mouth and…

Age at interview 64

Gender Female

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Sharon ‘couldn’t put up with’ the side effects of oxybutynin. She found she got more bladder…

Age at interview 52

Gender Female

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Richard took several medicines for bladder spasms, including baclofen, oxybutynin and diazepam…

Age at interview 59

Gender Male

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Medicines controlled Iain’s bladder spasms reasonably well (see above), but sometimes he had ‘intractable spasms’ which didn’t respond. He plans to have some injections of botulinum toxin (Botox) which can reduce nerve-related bladder spasms in children and adults. It prevents nerves from releasing the transmitter substance that tell muscles to contract. Botox is injected directly into the bladder muscle wall. The doctor examines the bladder via the urethra, using a cystoscope, and then injects the Botox into the bladder wall using a special needle passed through the cystoscope. The procedure is done under local or general anaesthetic.

Iain sometimes gets ‘intractable’ bladder spasms because of his multiple sclerosis. A urologist…

Age at interview 35

Gender Male

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While Botox injections reduce the frequency and severity of bladder spasms in many patients, in some people they don’t and, occasionally, symptoms get worse. Other side effects include difficulty in passing urine. Some people cannot pass urine at all and have to self catheterise or have an indwelling catheter until Botox wears off. How long the effects of the injection last varies among patients.

 

Catheter changes

Frequency of catheter changes How long an indwelling catheter can be left in place depends on what the catheter it is made of, whether or...

Getting catheter equipment

Catheters and other items such as drainage bags are prescribed by the doctor. Some pharmacies have to order the catheters and other equipment, so advise...