Micturition disorders in multiple sclerosis patients: neurological, neurourodynamic and magnetic resonance findings

Abstract

Micturition disorders are frequent in an advanced course Of multiple sclerosis. Historical records of multiple sclerosis patients reveal that urinary Symptoms Occur with high frequence. In the present study we have investigated all patients who were admitted to our Multiple Sclerosis Center in a 1 Year period. All patients underwent a neurological examination corroborated by MRI investigation. Out of 101 Patients, 75 who reported urinary symptoms, underwent neurourodynamic investigation. Sixty of them exhibited functional micturition abnormalities, which were strictly correlated to EDSS, pyramidal and cerebellar functional statuses SCOreS. Detrusor hyperreflexia was the commonest abnormality. Neurourodynamic findings were also correlated to the burden of lesion, although MRI seems to fail in localizing specific neural pathways which control micturition phases. Moreover, urodynamic evaluation can select different groups of MS patients with different degrees of neurological impairment.

Prevalence of Lower Urinary Tract Symptoms in People with Multiple Sclerosis

“…Of the 22 studies that met the inclusion criteria, nine were not included in the meta-analysis because the methods of data collection were not described in sufficient detail to allow accurate interpretation of the findings, [24][25][26][27][28][29][30][31][32] and one additional study provided prevalence estimates of OAB with no details given for single symptoms to enable pooling of the data for meta-analysis. 33 Some urinary symptoms in two studies were not included in the final analysis because the terminology was inconsistent with the ICS classification or the urinary symptoms were combined, making prevalence estimates for individual ICS categories not possible.…”

Disorders of micturition in neurological patients A clinical study of 786 patients

“…Table 2 shows the urodynamic abnormalities found in each neurological disease and the frequency of the single urodynamic patterns. We define the five classes identified as follows: (according to Patti et al [ 19] 1. Detrusor hyperreflexia, characterized by a lowered threshold of detrusor micturition reflex and lack of voluntary suppression upon request.…”

Systematic Review of the Epidemiology of Urinary Incontinence and Detrusor Overactivity among Patients with Neurogenic Overactive Bladder

“…For example, bladder dysfunction has been shown to correlate with disability status in patients with MS [20] , voiding dysfunction has been shown to develop progressively with advancing disease in patients with PD [30] , and the type of bladder dysfunction is significantly associated with the degree of injury in patients with SCI [44] . In addition, patients are often reluctant to discuss symptoms with their health care providers, so it is difficult to assess at what point over the course of the disease they experienced UI and/or DO [45] .…”

“…A total of 45 studies reported rates of urological symptoms in patients with MS. The prevalence of these symptoms ranged from 6.9% (defined as incontinence) in an Italian single-center study of 101 unselected patients [20] to 95% (defined as symptomatic voiding dysfunction) in a Japanese study of 32 patients referred for neurourological evaluation [21] . The prevalence of detrusor hyperreflexia ranged from 27% in a sample of consecutive patients admitted to 2 neurological centers in Italy [22] to 91% among 70 patients who underwent cystometric evaluation in a UK study [9] .…”