Specificity of Lower Urinary Tract Symptoms in Neuromyelitis Optica in Comparison With Multiple Sclerosis Patients

Abstract

PurposeThe aim of this study was to describe lower urinary tract symptoms in neuromyelitis optica (NMO), and to compare these data with urinary disorders observed in multiple sclerosis (MS) patients.MethodsRetrospective study of data collected from January 1997 to July 2017 using the database from a Neuro-Urology Department of a university hospital. NMO and MS patients were matched for sex, age, and Expanded Disability Status Scale (EDSS)ResultsTwenty-six patients with NMO were included and compared with 33 MS patients. Mean age was 41.6 years (standard deviation [SD], 14,8), mostly female patients (24 vs. 2 males). Mean EDSS was 4.6 (SD, 1.8) in the 2 groups. In NMO group, 57% of the patients (n=15) had overactive bladder with urgency and urge incontinence and 38.5% (n=10) of them had nocturia. Voiding symptoms was observed in 69.2% of the patients (n=18); 42.3% of NMO patients performed self-intermittent catheterization versus 12.1% in MS patients (P=0.012). Low bladder compliance and severe urinary tract infections (pyelonephritis) were more frequent in NMO than in MS patients (respectively 15% vs. 0%, P=0.016 and 42% vs. 12%, P=0.024).ConclusionsLower urinary tract symptoms, especially overactive bladder and urinary retention, are frequent in NMO. Low bladder compliance, serious urinary infections, and high prevalence of urinary retention requiring self-intermittent catheterization are the main symptoms significantly more frequent than in MS.

Refractory hyponatremia in neuromyelitis optica in a pediatric patient

“…[1] Urgency, nocturia, urinary incontinence, and voiding symptoms were reported as most frequent symptoms. [1] Urinary tract infection was diagnosed in our case during hospitalization and follow-up, and it could be related to voiding symptoms. Hyponatraemia could be caused from multiple factors, and one of infamous causes being the SIADH, which could possibly be caused from disorders of the central nervous system.…”

“…AUR is less common in women compared to men, and possible cause including neurological, anatomical, myopathic, infective, pharmacological, or functional [12] . It was reported that urinary complication was more severe in NMOSD than multiple sclerosis, and spinal injury caused by myelitis could be a reasonable explanation [1] . Urgency, nocturia, urinary incontinence, and voiding symptoms were reported as most frequent symptoms [1] .…”

“…Neuromyelitis optica (NMO) is a rare inflammatory and autoimmune demyelinating disease predominantly involving the optic nerves and spinal cord. Spinal injury caused by myelitis could be a reasonable explanation for urinary complication [1] . Moreover, syndrome of inappropriate antidiuretic hormone secretion (SIADH) or other autoimmune diseases have been reported as comorbidities of NMO [1,2] .…”

“…Spinal injury caused by myelitis could be a reasonable explanation for urinary complication. [1] Moreover, syndrome of inappropriate antidiuretic hormone secretion (SIADH) or other autoimmune diseases have been reported as comorbidities of NMO. [1,2] However, almost all cases of NMO or neuromyelitis optica spectrum disorder (NMOSD) associated with SIADH and hyponatremia and urinary complication are reported in adulthood.…”

Understanding of Neurological Diseases

“…Nonetheless, LUTS can play a key role for the differential diagnosis of neurologic diseases that show similar symptoms, such as neuromyelitis optica (NMO) and multiple sclerosis (MS). Declemy et al [5] investigated differences in the LUTS experienced by patients between NMO and MS. NMO patients frequently experienced OAB and urinary retention, whereas low bladder compliance, serious urinary tract infections, and urinary retention were commonly observed in MS patients. As the survival rate of cancer patients is increasing, concerns about the functional changes caused by cancer treatment have emerged.…”