Relationship Between Lower Urinary Tract Abnormalities and Disease-Related Parameters in Multiple Sclerosis

Koldewijn, Evert L.; Hommes, O. R.; Lemmens, W.A.J.G.; Debruyne, F.M.J.; Kerrebroeck, Philip E. V. A. Van

doi:10.1097/00005392-199507000-00054

Cited by 24 publications

(46 citation statements)

References 26 publications

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“…7,11,14 Our ®ndings con®rm a statistically signi®cant positive relationship between disease duration and micturition complaints 7 (Table 2). On the other hand, we did not ®nd a signi®cant relation between lower urinary tract symptoms and the disability status, when considering four classes of patients, each including two groups, according to the Kurtzke disability status scale (Table 2).…”

Section: Discussionmentioning

confidence: 53%

“…Some authors 14 have already reported that multiple sclerosis patients with a short disease duration can su er from serious voiding problems, but usually micturition problems appear related to the disability status. 7,11,14 Our ®ndings con®rm a statistically signi®cant positive relationship between disease duration and micturition complaints 7 (Table 2).…”

Section: Discussionmentioning

confidence: 99%

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Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

et al. 1997

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The lower urinary tract is a ected by multiple sclerosis in many patients. We screened urologically and neurologically 120 patients with a con®rmed diagnosis of multiple sclerosis. The mean age was 42 years (range 22 to 69 years). Urodynamic investigation as well as neuro-urophysiological investigations were performed in all patients. Renal ultrasound was used to study morphology, and excretory urogram (IVU) was used to assess renal function and the upper urinary tracts in 105 patients. Obstructive symptoms were found more commonly than irritative symptoms. The urinary symptoms were found to be related to disease duration and not to disability status. Urodynamic abnormalities were statistically signi®cantly related to disease duration (X 2 =38.51; P=0.0001), and to the disability status (X 2 =76.70; P=0.0001). Few patients, only 3.3%, had upper urinary tract dilatation. With medical management, hydronephrosis disappeared in all of the patients and did not recur. A combination of oral pharmacological agents and clean intermittent catheterization was used in the majority of the patients.We conclude that lower urodynamic abnormalities can be present in every patient with multiple sclerosis, and appear to be related to disease duration and disability status, thus early treatment based upon urodynamic evaluation and close follow-up can reduce morbidity and improve the quality of life.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

et al. 1997

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“…Unlike the bladder dysfunction that follows spinal cord injury and causes life-threatening upper urinary tract conditions, MS very rarely causes severe upper urinary tract involvement but rather results in morbidity that influences the quality of life [9].…”

Section: Discussionmentioning

confidence: 99%

Solifenacin in Multiple Sclerosis Patients With Overactive Bladder – A Prospective Study

Rey¹,

Heesakkers²

2006

European Urology Supplements

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Objective. To assess the efficacy and the effect on Qol of solifenacin for the treatment of OAB in MS patients. Patients and Methods. Thirty MS patients suffering from OAB were treated with solifenacin 5/10 mg for 8 weeks. The first 4 weeks patients received solifenacin 5 mg. At week 4 patients could request a dose increase to 10 mg. The efficacy was evaluated at 8 weeks. Results. After 4 weeks of treatment, 28 patients reported acceptable or no side effects. 17 continued the study with the 10 mg dosage, and 11 stayed on 5 mg solifenacin. Two patients withdrew from the study due to side effects. Solifenacin 5/10 mg for 8 weeks resulted in a significant decrease in number of micturitions and number of pads used per day compared to baseline. Also the severity of urgency prior to voiding decreased significantly, and an increase was seen in the volume per void. Twenty out of 30 patients chose to continue solifenacin therapy after termination of the study. The majority of patients reported global QoL improvement. Conclusions. Solifenacin is effective in the treatment of MS patients with OAB symptoms. This is the first study with solifenacin in a specific neurogenic patient group with a neurogenic disease-specific QoL outcome measure (MS-QoL 54).

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“…24 In previous studies a statistical correlation was found between detrusor hyperactivity or detrusor hypoactivity with disease duration, disability and neurophysiological ®ndings. 26 Cortical evoked potentials following stimulation of the pudendal nerve were delayed in a high percentage of MS patients with bladder dysfunction, 27 however the real impairment rate of the pSEP is at present not well known in early stages of MS. Classical multimodality evoked potentials recorded in our patients showed an abnormality rate of 68.7%.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of the somatosensory evoked potentials of the pudendal nerve in diagnosis of probable multiple sclerosis

Siracusano

Aiello

et al. 1999

Spinal Cord

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Study design: The aim of the study was to evaluate the sensitivity of pSEP in patients a ected by probable MS. Objectives: Bladder dysfunction is the presenting symptom in 2% of patients a ected by multiple sclerosis (MS) and may be present in up to 78% of them. Abnormalities of somatosensory evoked potentials of the pudendal nerve (pSEP) have been found by many authors in patients a ected by clinically de®ned MS, but little is known of diagnostic reliability of pSEP in early stage of MS. Methods: Sixteen patients, eleven females and ®ve males, aged between 18 and 45 years old (mean age 28.9), a ected by clinically probable MS, were studied. Six of them reported retention or urge incontinence. pSEP with P1 (P40) scalp wave was analyzed. All patients also underwent visual evoked potentials (VEP), SEP of median and tibial nerves (mSEP, tSEP), brainstem acoustic evoked potentials (BAEPs), MRI of the brain and cerebrospinal¯uid (CSF) evaluation. Urodynamic study with simultaneous measurement of intravesical, intraurethral and abdominal pressures with external sphincter electromyography was performed. Results: Abnormalities of the evoked potentials were found in all patients. Abnormalities of the pSEP were observed in all the symptomatic cases and in eight of the remaining ten patients; ten showed no responses from the scalp and four showed P1 increased latency. Urodynamic abnormalities were found in 12 patients and MRI showed demyelinating lesions in 13 patients and oligoclonal bands were found in eight of them. Conclusion: pSEP can be worthwhile as part of the initial diagnostic evaluation in patients a ected by MS. It provides information of diagnostic relevance and plays a role in screening patients for urodynamic testing, which, however, is more speci®c for detecting urethrovesical dysfunctions and preventing urological complications.

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Relationship Between Lower Urinary Tract Abnormalities and Disease-Related Parameters in Multiple Sclerosis

Cited by 24 publications

References 26 publications

Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

Solifenacin in Multiple Sclerosis Patients With Overactive Bladder – A Prospective Study

The usefulness of the somatosensory evoked potentials of the pudendal nerve in diagnosis of probable multiple sclerosis

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