Management strategies for neurogenic lower urinary tract dysfunction: a qualitative study of the experiences of people with multiple sclerosis and healthcare professionals

Abstract

Purpose

Urinary symptoms are highly prevalent among people with MS. This study aimed to explore the experiences of people with MS and HCPs in managing urinary symptoms and explore their views on using TTNS to treat urinary symptoms.

Materials and methods

Audio-recorded semi-structured, interviews were employed with people with MS and HCPs. All transcribed interviews were exported to NVivo software (Version 12) and analyzed using a reflexive approach to thematic analysis.

Results

Four main themes were identified; The wide-ranging negative impacts of urinary symptoms (“It’s limited everything else”), Gaps in urinary services (“Is there somebody like that, sort of specialized in that area?”), Management strategies (“I don’t go too far from the toilet in case I need to use one”), and optimism about TTNS (“Are you giving Me Hope?”).

Conclusion

Urinary symptoms are common and very troublesome for people with MS. Despite their prevalence, many people with MS continue to suffer in silence. People with MS require skilled multidisciplinary services guided by clinical care pathways to improve service provision and to address urinary symptoms. HCP’s and people with MS are open to the use of TTNS for urinary symptoms and have clear preferences for location and duration of intervention delivery.

Implications for rehabilitation

• Urinary symptoms are very common and troublesome for people with multiple sclerosis, yet many continue to suffer in silence.

• People with multiple sclerosis lack knowledge about treatment options for urinary symptoms.

• There is an on-going need for healthcare provider education on guidelines for screening and managing urinary symptoms in people with MS and the role of specialist urinary service providers.

• HCP’s and people with MS are open to the use of TTNS for urinary symptoms.

Keywords:

• Multiple sclerosis
• neurogenic bladder
• management strategies
• qualitative study
• lower urinary tract dysfunction

Acknowledgments

The authors would like to express their special thanks and appreciation to the participants for their time and engagement and to MS Ireland gatekeepers for their help during the recruitment phase. We also extend our special thanks to Dr Ben Meehan for his cooperation and support for using NVivo software.

Disclosure statement

No potential conflict of interest.

Additional information

Funding

Ms Al Dandan is a PhD student at the University of Limerick funded by Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (tuition paid by the Saudi cultural commission as part of higher education program).