Behavior therapy for urinary frequency in a patient with neurogenic bladder: a case report

Area of Science:

• Urology
• Neurology
• Behavioral Medicine

Background:

• Multiple sclerosis (MS) can cause neurogenic bladder dysfunction, leading to urinary frequency and incontinence.
• This case study focuses on a 32-year-old female patient with a seven-year history of MS experiencing exacerbation of symptoms, including urinary issues.

Observation:

• The patient was diagnosed with a neurogenic (spastic) bladder, characterized by reflexive voiding at approximately 100 ml urine accumulation.
• A behavioral management program involving feedback and goal-setting was implemented to address the patient's urinary symptoms.

Findings:

• The treatment involved daily recording of voiding times and volumes, with goal-setting for increased intervals between voidings.
• After 13 days, the average duration between voidings increased from 58 minutes to 130 minutes.
• The average voided urine volume increased from 95 ml to 160 ml, with sustained gains at three and six-month follow-ups.

Implications:

• Behavioral interventions show promise in managing neurogenic bladder symptoms in patients with multiple sclerosis.
• The findings suggest that goal-setting and feedback can effectively improve bladder capacity and reduce urinary frequency.
• While significant improvements were noted, further research may explore methods to extend voiding intervals beyond two hours.