Diagnosis and therapy for neurogenic bladder dysfunctions in multiple sclerosis patients

Popolo, Giulio Del; Panariello, Giovanni; Corso, F. Del; Scisciolo, G. de; Lombardi, Giuseppe

doi:10.1007/s10072-008-1042-y

Cited by 39 publications

(25 citation statements)

References 20 publications

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“…1 MS patients frequently suffer from urinary complaints. [2][3][4] De Seze and colleagues 5 report a prevalence of 37-99% for overactive bladder syndromes, characterized by irritative bladder symptoms, a prevalence of 34-79% for obstructive symptoms and 25% for chronic urinary retention.…”

Section: Introductionmentioning

confidence: 99%

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment

Akkoç

Ersöz²,

Yüceyar

et al. 2016

The Journal of Spinal Cord Medicine

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Objective: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. Design: Survey study. Setting: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. Participants: Consecutive MS patients scheduled for outpatient follow-up (n = 309). Intervention: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. Results: The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002). Conclusion: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.

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Section: Introductionmentioning

confidence: 99%

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment

Akkoç

Ersöz²,

Yüceyar

et al. 2016

The Journal of Spinal Cord Medicine

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“…However, bladder dysfunction can be prevented or symptomatically treated through various strategies, including pharmacologic therapies and behavioral approaches. [25][26][27][28][29][30][31] Del Popolo et al 29 concluded that behavioral rehabilitation and conservative treatments for bladder dysfunction are sufficient for most MS patients, with innovations in neurourology improving urologic function and QOL for patients not responding to firstline treatments. Options for bladder management in MS care have improved, and more patients are receiving effective treatment, with bladder problems often treated at the same clinic providing neurologic care.…”

Section: Bladder Dysfunctionmentioning

confidence: 99%

Caregiver Burden Among Informal Caregivers Assisting People with Multiple Sclerosis

Buchanan¹,

Radin²,

Huang³

2011

International Journal of MS Care

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Multiple sclerosis (MS) burdens not only patients but also their informal or family caregivers. This study was conducted to identify characteristics of caregivers, caregiving, and MS patients receiving informal care that are associated with caregiving burden. Data were collected through a national survey of informal MS caregivers and analyzed using an ordered logistic regression model to identify factors associated with burden. Burden was found to be significantly greater among male caregivers than among female caregivers. Moreover, greater burden was associated with more frequent patient bladder dysfunction, more hours per week spent providing assistance, and greater restriction on the caregiver's ability to perform daily activities because of caregiving responsibilities. A strong association was found between the mental health status of the caregiver and burden. Health professionals should be sensitive to the impact of caregiving on the mental health of MS caregivers. The results of this study suggest that treating patient bladder dysfunction and facilitating respite care may reduce burden and improve the mental health of informal caregivers of people with MS. Future research should identify programs and services designed specifically to reduce burden experienced by male caregivers. Int J MS Care. 2011;13:76-83.

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“…5,6 Although our patient had no neurological symptoms and no pathological neurological finding on physical examination, we performed cranial and lumbosacral magnetic resonance imaging to exclude neurogenic causes of atonic bladder. Neither multiple sclerosis nor lumbar disc protrusion or cauda equina syndrome was detected.…”

Section: Discussionmentioning

confidence: 94%

Idiopathic giant atonic bladder (6000 mL in volume) that is present for 15 years with no urinary symptoms

Yorulmaz

Kısmet

et al. 2013

CUAJ

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Urinary retention is common in patients with neurologic disorders. We present a case of asymptomatic idiopathic giant bladder from which 6000 mL urine was drained. This is the largest volume of bladder that we found in the literature. T he urinary bladder is an unusual structure in that it is autonomically innervated yet functions under voluntary control. Although it is well-known that patients with a variety of neurological diseases suffer disturbances of continence and micturition, the precise ways in which these disorders affect the neurophysiological mechanisms of the bladder are poorly understood. Indeed, when a patient presents with urinary dysfunction, it is often difficult to be certain whether there is a neurological basis for the symptoms, or whether they are purely the result of a local abnormality, such as bladder outflow obstruction. 1 We present a case of giant bladder from which 6000 mL urine was drained via a urinary catheter. This is the largest volume of bladder that we found in the literature. The patient was asymptomatic except for abdominal distention, and we could not find any disorder that might be the cause of this massive bladder distention. Case reportA 62-year-old male was admitted to our hospital with the complaint of rectal bleeding after defecation for 2 months. He also lost 3 kilograms of weight during this period. On physical examination, significant abdominal distention was detected (Fig. 1). From the patient's history, we learned that he had a gradual increase of this distension for 15 years. He had no urinary complaints. A vegetative and polipoid mass was detected in the rectum 8 to 10 cm from the anal verge by rectoscopy and biopsies were taken. After having the histopathologic diagnosis as adenocarcinoma of the rectum, the patient underwent surgical operation. All preoperative laboratory tests, including urea and creatinine, were within normal values. Preoperative ultrasonography revealed a 24 × 23-cm cystic mass filling abdomen and pelvis. Computerized tomography (CT) also confirmed a 24 × 23 × 13-cm cystic mass with a delicate capsule and firm septations that supposedly originated from the mesentery (Fig. 2). The bladder could not be visualized probably due to inadequate filling with radiopaque substance. The rectal wall was thick along 5 cm of length. In the operating room, a urinary catheter was inserted for urinary outflow follow-up. After catheterization, 6000 mL of urine was drained, and the abdominal distention disappeared (Fig. 3). Laparotomy was performed and it was seen that there was no cystic mass in the abdominal cavity except for atonic bladder; so we decided that the cause of abdominal distention was atonic bladder, not another cystic mass (Fig. 4). Low anterior resection was performed. The tumour did not invade surrounding tissues and it was easily removed. Anastomosis was performed by stapler. A giant atonic bladder was detected, and a urologist was consulted during surgery. Since the patient had no obvious urinary complaints until the operation, he ...

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Diagnosis and therapy for neurogenic bladder dysfunctions in multiple sclerosis patients

Cited by 39 publications

References 20 publications

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment

Caregiver Burden Among Informal Caregivers Assisting People with Multiple Sclerosis

Idiopathic giant atonic bladder (6000 mL in volume) that is present for 15 years with no urinary symptoms

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