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

Araki, Isao; Matsui, Masaru; Ozawa, Kyoko; Nishimura, Masataka; Kuno, Sadako; Saida, Takahiko

doi:10.1007/s00415-002-0775-4

Cited by 34 publications

(38 citation statements)

References 29 publications

(74 reference statements)

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“…Similarly, in a prospective study of symptomatic MS patients, no significant correlation was found between clinical features and urodynamic patterns [5]. Instead, Betts et al showed that MS patients with irritative bladder symptoms and lower limb pyramidal involvement were highly likely to have detrusor hyperreflexia, such as to make unnecessary to run the urodynamic study to choose the anticholinergic therapy [7]; similarly Araki et al found that urinary irritative symptoms reflect the disease severity [9]. Betts et al reported a linear progression of residual urine volume with bladder FS score, and suggested to perform the post-void urine volume measurement only in patients with significant disability [7].…”

Section: Discussionmentioning

confidence: 99%

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Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Haggiag

Bolla

Picconi³

et al. 2017

Mult Scler Demyelinating Disord

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Objective: To assess the association between objective bladder function parameters in relation to urinary symptoms, and to analyze the sensitivity and specificity of subjective urinary symptom-assessment in predicting objective bladder dysfunction in a multiple sclerosis (MS) population. Methods: Consecutive MS patients with Expanded Disability Status Score (EDSS) ≤7.0 were included in this prospective study. In a single visit, patients were evaluated for the presence of urinary symptoms, then assessed for the following urological parameters: maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and detrusor sphincter dyssinergia (DSD). Results: One hundred nine subjects were included with a mean disease duration of 12.5 ± 8.7 years, 90.8% had a relapsing-remitting course; the mean EDSS score was 2.6 ± 1.7. Overall, 53.5% complained of at least one urinary symptom, and the most reported one was urgency (40.7%), followed by frequency (15.7%) and incomplete emptying (12.0%). Abnormal values were found for Qmax in 34.9%, for PVR in 40.4% of participants; DSD was diagnosed in 33.9% of the cases. Only Qmax was found negatively associated with the EDSS score (p = 0.007), but no other association was observed. The presence of urinary symptoms was poor predictor of bladder dysfunction, urgency among the others showed relatively higher predicting value. Conclusions: Subjective urinary symptoms assessment failed in predicting bladder function. Our results confirmed the value of objective urological assessment in patients with MS, irrespective of the presence of urinary symptoms.

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Section: Discussionmentioning

confidence: 99%

“…Few and heterogeneous studies have investigated the relationship between subjective urinary complaints and objective urological parameters in MS patients, reaching different conclusions [3,[5][6][7][8][9]. Is a routinary evaluation of urinary symptoms sufficient to exclude the presence of bladder dysfunction in patients with MS?…”

Section: Introductionmentioning

confidence: 99%

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Haggiag

Bolla

Picconi³

et al. 2017

Mult Scler Demyelinating Disord

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“…Therefore we could also speculate that pathomechanisms of spastic paraparesis might be applied to bladder smooth muscle, which result in DHIC. With regard to multiple sclerosis, several reports revealed that many patients show both storage and voiding symptoms and urinary symptoms correlated with disease severities [Ciancio et al, 2001;Araki et al, 2002]. Araki et al [2002] showed that among the lesions in the central nervous system, only the presence of a spinal cord lesion was related to the degree of urinary symptoms.Therefore, DHIC in multiple sclerosis might be caused by mechanisms similar to those occurring in spinal cord lesions.…”

Section: Discussionmentioning

confidence: 99%

Neurological diseases that cause detrusor hyperactivity with impaired contractile function

Yamamoto

Sakakibara

Uchiyama

et al. 2006

Neurourology and Urodynamics

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“…1 Storage symptoms correlate well with the Expanded Disability Status Scale (EDSS) 9 and pyramidal tract involvement; however, their association with voiding symptoms is much weaker. 10 LUTS in MS may be influenced by gender and age. While their exact impact on patient symptoms has not been thoroughly investigated, cumulative action of other diseases is possible, eliciting bladder dysfunction -benign prostate obstruction, pelvic relaxation, or stress urinary incontinence (SUI).…”

Section: Prevalence Of Luts In Msmentioning

confidence: 99%

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

Aharony¹,

Lam²,

Corcos³

2017

CUAJ

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Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time-and disease course-related. MS plaque location (intracranial and/or spinal) is a key feature in the pathophysiology of disease-related lower urinary tract symptoms (LUTS). The prevalence of these symptoms in MS patients is very high, with nearly 90% of them experiencing some degree of voiding dysfunction and/or incontinence. LUTS rarely present as primary MS manifestations and usually appear 6-8 years after the initial diagnosis. Symptom severity usually correlates with the disability status of patients.Patient assessment comprises clinical and advanced investigations. Each patient should be evaluated uniquely, after taking into account his/her symptoms, disease course and length, comorbidities, physical status, and medications. Basic investigation includes detailed history-taking, physical examination, and post-void residual volume measurement. Advanced evaluation consists of imaging and specific testing, with pivotal importance on urodynamic study.

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

Abstract: Urinary symptoms, especially irritative symptoms, reflect the condition of the disease. Thus, the quantified urinary symptoms may assist neurological diagnosis.

Cited by 34 publications

References 29 publications

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Neurological diseases that cause detrusor hyperactivity with impaired contractile function

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

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