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

Abstract

Multiple sclerosis affects the lower urinary tract in many patients. The relationship between lower urinary tract abnormalities and disease-related parameters of multiple sclerosis is not well described. We screened urologically and neurologically 212 patients according to a standard protocol. Micturition complaints were noted in 52% of the patients and urodynamic abnormalities were found in 64%. A statistical correlation was found between detrusor hyperactivity and detrusor hypoactivity with disease-related parameters, that is disease duration, disability status, myelin basic protein concentration in the cerebrospinal fluid and neurophysiological investiga tions. No relationship was found between detrusor hypersensibility or detrusor hyposensibility and the aforementioned disease-related parameters. In 1 patient upper urinary tract abnormal ities were noted in combination with urodynamic abnormalities. We conclude that lower urinary tract abnormalities can be found in every patient with multiple sclerosis unrelated to the state of the disease. Severe upper urinary tract abnormalities are rare.

Quality of life in women with multiple sclerosis and overactive bladder syndrome

“…The estimated prevalence of lower urinary tract symptoms (LUTS) in MS varies between 10 and 97%, this variability being mainly due to the differences in the sampling procedures of studied populations [2,8,9]. Among LUTS, those recognized as the most limiting in female patients are storage symptoms, such as daytime frequency, nocturia, urgency, and urge incontinence, which represent the symptoms of OAB [3].…”

Mechanisms and current treatments of urogenital dysfunction in multiple sclerosis

“…It has been reported that there is a correlation between the duration of MS and disability [11]. In the early stage of the disease, a low percentage of MS patients have urological complaints, sometimes associated with other neurological symptoms [13,18], although there may be evidence of urological dysfunction in clinically silent patients [3].…”

“…Five possible urodynamic patterns can be found in MS [11]: a) Detrusor hyperreflexia without obstruction hyperreflexia b) Detrusor hyperreflexia with outlet obstruction (detrusor external sphincter dyssynergia -DSD) c) Detrusor hyperreflexia with impaired contractility d) Detrusor areflexia e) Normal function.…”

Relationship between urinary symptoms and disease-related parameters in multiple sclerosis

“…This variability seems to be mainly due to the difference in the sampling procedure of patients. In fact, the variability of the incidence was clearly less (32 ~ 52 %), when the patients were consecutively sampled, regardless of lower urinary tract symptoms (LUTSs) [4,6,19,25,31]. The previous reports from Western countries have indicated that the irritative (storage) symptoms are predominant urinary symptoms in MS [1, 4, 6-8, 13, 14, 19, 24, 25, 31], whereas the prevalence of obstructive (emptying) symptoms symptom score, lower urinary tract symptoms were quantitatively evaluated in all patients with multiple sclerosis who had visited our neurological department during three months.…”

“…For example, the prevalence of LUTSs seems to be related to the disease severity [4,7,19,24], but the relation between LUTSs and the disease duration or the age is controversial [4,8,19,24]. The micturition reflex is mediated by the spinobulbospinal pathway via the pontine micturition center that is modulated by higher centers in the cerebral cortex [12].…”