Urinary Dysfunction in Multiple Sclerosis, Neuromyelitis Optica, and Related Disorders

Sakakibara, Ryuji

doi:10.1007/978-981-99-1659-7_62

Cited by 1 publication

(1 citation statement)

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“…Specific urotherapy includes specific treatment such as pelvic floor muscle training, pelvic floor biofeedback and electrical stimulation, alarm treatment, and neuromodulation [24] and is recommended in case of first line treatment failure. Moreover, urodynamic patterns may vary over time and sometimes tests can be normal in symptomatic patients (this situation is estimated to be present in 1-34% of patients) [20,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Lower Urinary Tract Dysfunction in Pediatric Patients with Multiple Sclerosis: Diagnostic and Management Concerns

Sollini,

Pellegrino,

Barone

et al. 2024

Children

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Background: Multiple sclerosis (MS) is increasing in the pediatric population and, as in adults, symptoms vary among patients. In children the first manifestations can sometimes overlap with acute neurological symptoms. Urological symptoms have not been much studied in childhood. We shared our experience with MS urological manifestation in children. Methods: This article is a retrospective evaluation of all children with MS, according to the Krupp criteria, who also present with urological symptoms. We collected demographic and clinical history, the MR localization of demyelinating lesions, urological symptoms, and exams. Results: We report on six MS pediatric cases with urological manifestation. Urinary symptoms, characterized by urinary incontinence in five patients and urinary retention in one patient, appeared in a different time frame from MS diagnosis. Urodynamic exams showed both overactive and underactive bladder patterns. Treatment was defined according to lower urinary tract dysfunction, using clean intermittent catheterization, oxybutynin, and intradetrusor Onabotulinum Toxin-A injection. A low acceptance rate of invasive evaluation and urological management was observed. Conclusions: The MS diagnosis was traumatic for all our patients. We believe it is important to address urological care in young people from the time of diagnosis for prompt management; it could be useful to include a pediatric urologist in multidisciplinary teams.

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