Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis.

Betts, C. D.; D'Mellow, M T; Fowler, Clare J.

doi:10.1136/jnnp.56.3.245

Cited by 265 publications

(208 citation statements)

References 32 publications

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“…"I Detrusor hyperreflexia is present in patients with multiple sclerosis with lower limb pyramidal involvement and has been attributed to interruption of pathways between the pons and the sacral cord. 20 …”

Section: Discussionmentioning

confidence: 99%

Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

Stocchi

Carbone

Inghilleri

et al. 1997

Journal of Neurology, Neurosurgery & Psychiatry

153

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Aims-To determine whether Parkinson's disease and multiple system atrophy each has a distinct pattern of micturition abnormalities and whether a urodynamic evaluation could be useful in the differential diagnosis between the two diseases. Methods-Sixty two patients (30 with Parkinson's disease and 32 with multiple system atrophy) underwent a complete urodynamic evaluation and neurophysiological testing. Results-Of the parkinsonian patients 36-6% had normal micturition findings with normal bladder sensitivity; 26-7% had delayed or incomplete pelvic floor relaxation; 26-7% had hyperreflexia with vesicosphincteric synergy; and 10% had hyperreflexia with vesicosphincteric synergy associated with incomplete pelvic floor relaxation. Parkinsonian patients with a normal urodynamic pattern had significantly less severe disease and a shorter duration of disease in years than those who had abnormal patterns. Patients with hyperreflexia had significantly higher severity of disease. All the patients with multiple system atrophy had hyperreflexia with synergy. Two urodynamic patterns were identified: hyperreflexia with vesicosphincteric synergy (90-6% of patients), and hyperreflexia with vesicosphincteric synergy and incomplete pelvic floor relaxation (in 9.4%). Hyperreflexia with synergy correlated neither with the severity nor with the duration of disease. Sphincter EMG analysis showed that all the parkinsonian patients had normal sphincter EMG whereas 24 of the 32 patients with multiple system atrophy had neurogenic signs.

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Section: Discussionmentioning

confidence: 99%

Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

Stocchi

Carbone

Inghilleri

et al. 1997

Journal of Neurology, Neurosurgery & Psychiatry

153

View full text Add to dashboard Cite

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“…Urinary symptomatology is polymorphic and, like its incidence, subject to change over time, but it tends to increase with disease progression and it is mainly the result of spinal cord involvement. The most frequent are storage symptoms (urinary frequency, urgency, and urge incontinence) while voiding symptoms (hesitancy, incomplete voiding and urinary retention) exist to a lesser degree [3]. Therapeutic options for storage symptoms vary and they include, with or without associated clean intermittent self-catheterization, conservative treatments such as anticholinergic drugs -although the published data provide limited evidence for their efficacy in MS [4,5].…”

Section: Introductionmentioning

confidence: 94%

Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Andretta

Simeone

Ostardo

et al. 2014

Journal of the Neurological Sciences

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Objective: Bladder dysfunctions are common in multiple sclerosis (MS) often causing the most distressing symptoms. The aim of this paper was to evaluate the effectiveness of sacral nerve modulation (SNM) in this disease. Methods: We conducted an observational retrospective survey in 17 patients treated with SNM in the north-east of Italy, all complaining of bladder symptoms (storage in 41%, voiding in 24%, mixed in 35%) unresponsive to conventional therapies, with a mean follow-up of 52 ± 26 months and mean Expanded Disability Status Scale score of 5.8 ± 1.8. Results: 75% of patients reported significant and lasting improvement in bladder symptoms and in quality of life. We observed a statistically significant improvement in frequency, urgency, number of pads, residual volumes, number of catheterizations and in the voided volumes. In 5 out of 6 cases with mixed symptoms the stimulation was discontinued (device totally explanted or turned off) after a mean time of 66 months (range 10-84 months) after the implant, for disease progression or loss of efficacy. Conclusion: SNM could be an option in very selected cases of storage and voiding symptoms refractory to conservative treatments caused by a stable or slowly progressive MS considering its minimal invasiveness and reversibility. The poor results observed suggest avoiding this therapy in mixed symptoms and in cases of advanced disability.

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“…The database created was analyzed for that period. The variables analyzed were age, gender, race, age of disease onset, type of evolution according to Lublin classification 4 , Expanded Disability Status Scale (EDSS) 15 , amount of years suffering the disease, treatment with interferons, glatiramer acetate or other medications and its side effects, Beck depression scale 16 , and urinary dysfunction symptoms through a questionnaire comprising fundamental questions regarding lower urinary tract symptoms 17 .…”

Section: Methodsmentioning

confidence: 99%

Clinical features of multiple sclerosis in the south of Brazil: a partial analysis

Finkelsztejn

Cristovam

Moraes

et al. 2009

Arq. Neuro-Psiquiatr.

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-There are no published studies on the characteristics of multiple sclerosis (MS) patients from the south of Brazil. Objective: To identify the clinical features of a series of MS patients and to compare to other Brazilian series. Method: Retrospective study with 67 patients followed in The MS Reference Center -RS, Brazil during the year of 2008. We analyzed demographic and clinical data. Results: Most were women (74.6%), the general average age was 43.5 years old, and the general average EDSS score was 4.1. Of those patients, 81.8% had relapsing-remitting MS. Sexual dysfunction prevalence was 31.1% in men and 68.9% in women (p<0.01). We found a positive correlation (Spearman=0.444, p<0.05) between EDSS and depressive symptoms. Conclusion: This study showed a very similar sample compared to other states of Brazil. Moreover, there was found a high prevalence of sexual dysfunction and a straight relation between EDSS and depressive symptoms.KEy WORDS: multiple sclerosis, epidemiology, depressive symptoms, sexual dysfunctions.Características clínicas da esclerose múltipla no sul do Brasil: uma análise parcial resumo -Não há dados publicados sobre as características clínicas da esclerose múltipla (EM) no estado do Rio Grande do Sul (RS). Objetivo: Identificar e comparar as características clínicas de uma série de pacientes com EM no RS com as de outras séries nacionais. Método: Foram coletados e avaliados dados demográficos e clínicos de 67 pacientes atendidos em nosso centro. Resultados: Houve predomínio de mulheres (74,6%), idade média geral foi de 43,5 anos e EDSS médio de 4,1. O tipo surto-remissão correpondeu a 81,8%. A prevalência de disfunção sexual foi de 31,1% nos homens e 68,9% nas mulheres (p<0,01). Encontrou-se correlação de 0,444 (p<0,05) entre depressão e EDSS. Conclusão: Este estudo demonstrou uma amostra semelhante às demais amostras brasileiras, apresentando, adicionalmente, elevada prevalência de sintomas sexuais e a estreita associação entre depressão e o grau de incapacidade. PALAVRAS-CHAVE: esclerose múltipla, epidemiologia, sintomas depressivos, disfunção sexual.

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Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis.

Cited by 265 publications

References 32 publications

Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Clinical features of multiple sclerosis in the south of Brazil: a partial analysis

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