Clinical Characteristics and Urodynamic Analysis of Urinary Dysfunction in Multiple Sclerosis

Abstract

Background:Both lower urinary tract dysfunction and urinary symptoms are prevalent in patients with multiple sclerosis (MS). Although the significance of identifying and treating urinary symptoms in MS is currently well-known, there is no information about the real prevalence and therapeutic effect of urinary symptoms in patients with MS. The purpose of this study was to analyze the major symptoms and urodynamic abnormalities, and observe the therapeutic effect in different MS characteristics.Methods:We enrolled 126 patients with urological dysfunction who were recruited between July 2008 and January 2015 in Beijing Tian Tan Hospital, Capital Medical University and conducted overactive bladder system score (OABSS), urodynamic investigation, and expanded disability status scale (EDSS). Changes of urinary symptoms and urodynamic parameters were investigated.Results:Urgency was the predominant urinary symptom, and detrusor overactivity was the major bladder dysfunction. There was a positive correlation between EDSS and OABSS. Clinically isolated syndrome (CIS) had lowest EDSS and OABSS. CIS exhibited significant improvements in OABSS, maximum urinary flow rate (Qmax), and bladder volume at the first desire to voiding and maximum bladder volume after the treatment (P < 0.05). Relapsing–remitting MS showed significant improvements in the OABSS, Qmax, and bladder volume at the first desire to voiding, maximum bladder volume and bladder compliance after the treatment (P < 0.05). Progressive MS exhibited significant increase in the bladder volume at the first desire to voiding, the detrusor pressure at maximum flow rate (PdetQmax), and bladder compliance after the treatment (P < 0.05).Conclusions:Urodynamic parameters examined are important in providing an accurate diagnosis, guiding management decisions of MS. Early and effective treatment may improve the bladder function and the quality of life at the early stages of MS.

Evaluation of Quality of Life among Patients with Multiple Sclerosis and voiding dysfunction: A Cross-Sectional Study

“…MS with focal demyelinating lesions at different levels of the central nervous system (CNS) leads to urinary dysfunction. [29] In the present study 41.3% of patients had moderate to severe urinary symptoms. This finding was similar to the findings of the study by Sammarco with 43% moderate to severe bladder dysfunction among patients with MS. [14] The high prevalence of LUTS suggests the complexity of neural control of the function of the bladder and urinary tract in health and the location and nature of the neural lesions determines the pattern of bladder dysfunction.…”

Evaluation of Quality of Life among Patients with Multiple Sclerosis and Lower Urinary Tract Symptoms: A Cross-Sectional Study

“…MS with focal demyelinating lesions at different levels of the central nervous system (CNS) leads to urinary dysfunction. [23] In the present study, the prevalence of LUTS was high among patients with MS (reaching to more than ¾ of the patients), and 41.3% of patients had moderate to severe urinary symptoms. This finding was similar to the findings of the study by Nakipoglu with an 80.81% prevalence of LUTS and the study by Sammarco with 43% moderate to severe bladder dysfunction among patients with MS. [13,24] The different estimates reported for the prevalence of LUTS in MS range between 32% and 97%, [25,26] and the high prevalence of LUTS suggests the complexity of neural control of the function of the bladder and urinary tract and the location and nature of the neural lesions determines the pattern of bladder dysfunction.…”

“…De Almedia reported prevalence rates of 63.5% and 100%, respectively, among patients with RRMS and primary progressive MS. [43] Moreover, a study by Wang et al showed the lowest OBASS score in patients with CIS. [23] In the present study, patients with MS and LUTS symptoms compared to LUTS-free patients had lower QOL scores in all dimensions except for health changes and there was a significant difference in the combined physical and mental health dimensions of QOL between the two groups with and without LUTS. In addition, there was a higher possibility of a urinary tract complication in patients with MS with a higher EDSS score.…”

The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis

“…Moreover, such an understanding provides a significant insight into the complicated MS pathophysiology and the mechanism of LUTS in the emergence of MS. These determinants contribute to the management of LUTS and improvement of quality of life (QOL) [15]. Performing epidemiological studies to evaluate the rate of specific symptoms among individuals with MS helps to describe the economic and social significance of the disease and assists in the identification, early diagnosis, and timely control of the complications of the disease [16], and identification of possible causes of the disorder, in addition to providing the foundation for higher level studies [17,18].…”