Which clinical risk factors determine a pathological urodynamic evaluation in patients with multiple sclerosis? an analysis of 100 prospective cases - Abstract

BACKGROUND:Urinary tract symptoms are an underestimated problem in multiple sclerosis (MS).

OBJECTIVE: Hundred urodynamics of MS patients have been evaluated prospectively.

DESIGN, SETTING AND PARTICIPANTS: In an inpatient rehabilitation, all persons with MS who also suffered from urinary tract symptoms received a voiding diary, post-void sonography and an urodynamic examination according to International Continence-Society-Standard.

RESULTS AND LIMITATIONS: Between 10/2009 and 3/2011, 100 patients (79 women; 21 men; mean EDSS, 4.52 ± 2.26) were examined who had primary progressive MS (9×), relapsing-remitting MS (41×), secondary progressive MS (43×) and CIS (1×). The mean duration of MS was 10.26 ± 10.09 years and mean duration of LUTS, 6.9 ± 7.75 years. Urodynamic testing showed normal findings in 22 patients, detrusor overactivity in 7, increased bladder sensation without detrusor overactivity in 21, detrusor-sphincter dyssynergia in 26, detrusor hypocontractility in 12, detrusor acontractility in 4 and unclear diagnosis in 8 patients. Statistically significant risk factors for pathological urodynamic findings were as follows: wheelchair dependency, use of more than one incontinence pad per day and a MS type other than relapsing-remitting.

CONCLUSIONS: The urodynamic investigation at hand showed urinary tract dysfunction in 78 of 100 MS patients with lower urinary tract symptoms (LUTS). The long latency between the occurrence of MS and/or the beginning of LUTS and the first neuro-urological evaluation indicates a deficit in treatment. Beyond national guidelines, all MS patients should at regular intervals be questioned about LUTS and receive urodynamic assessment especially according to the presented risk profile.

Written by:
Wiedemann A, Kaeder M, Greulich W, Lax H, Priebel J, Kirschner-Hermanns R, Füsgen I. Are you the author?
Urological Clinic, Ev. Krankenhaus Witten gGmbH, Pferdebachstr. 27, 58455, Witten, Germany.

Reference: World J Urol. 2012 Jan 7. Epub ahead of print.
doi: 10.1007/s00345-011-0820-y

PubMed Abstract
PMID: 22227822


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