For a purely spastic bladder the use of spasmolytic agents particularly anticholinergics is the usual first line of therapy. Drugs like Ditropan, Tofranil and Hytrin are often used in this setting. Not infrequently some combination of drugs and self-catheterization is required for optimal control. As many patients with bladder symptoms due to MS have associated spasticity of their legs, they are often treated with drugs that primarily reduce spasticity such as Lioresal and Zanaflex, sometimes with concomitant relief or reduction in bladder spasms. Neurontin, which sometimes helps spasticity also, may improve bladder symptoms for some.
Bladder spasms are also more common when the bladder is irritated as with infections.
As many patients with MS often do not have classic bladder infection symptoms and lack pain and may not recognize minor clouding or discolored urine, the rapid emergence of new bladder spasms demands evaluation with urinalysis and sometimes urine culture. Obviously, obtaining optimal control of bladder symptoms can be rather complicated. Evaluation by a urologist who frequently sees patients with MS and bladder symptoms is a necessity for patients whose symptoms do not come under control through the efforts of their neurologist or internist. I don't know if self-cath is an option because of numbness. Any suggestions will be appreciated.