How to manage bladder problems and nerve pain in NMOSD?

Question

Hello doctor,

My mom is 57 years old, and she has been living with NMOSD for about three years now. Honestly, it has been very hard to watch.

She is having a lot of trouble with bladder leakage and cannot always make it to the bathroom in time. She is so embarrassed about it that she does not even like talking about it. On top of that, the burning pain in her legs keeps her awake most nights.

How can a 57-year-old with NMOSD manage both bladder problems and nerve pain at the same time without it completely affecting her quality of life?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

The first step is to identify whether your mother's bladder is overactive, underactive, or not emptying completely, as the treatment depends on the underlying cause. I would suggest keeping a bladder diary, measuring the post-void residual (PVR) urine volume, and, if needed, performing urodynamic studies.

If she has an overactive bladder, medications such as Mirabegron or Vibegron are often good options because they are effective and tend to have fewer cognitive side effects than older anticholinergic medications.

If these medicines are not enough, bladder Botox injections can provide excellent control of urgency and leakage. If she is retaining urine, intermittent self-catheterization may be necessary to protect her kidneys and reduce the risk of infections.

For burning nerve pain, medications such as Gabapentin, Pregabalin, Duloxetine, or Amitriptyline are commonly used. The choice of treatment should be based on her symptoms and any other medical conditions she may have.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.