Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology II1 Apr 20121878 A SURPRISINGLY LOW PREVALENCE OF DEMONSTRABLE STRESS URINARY INCONTINENCE IN WOMEN WITH MULTIPLE SCLEROSIS FOLLOWED AT A TERTIARY NEUROUROLOGY CLINIC Benjamin Dillon, Casey Seideman, Michelle Van Kuiken, Dominic Lee, Elliot Frohman, and Gary Lemack Benjamin DillonBenjamin Dillon Dallas, TX More articles by this author , Casey SeidemanCasey Seideman Dallas, TX More articles by this author , Michelle Van KuikenMichelle Van Kuiken Dallas, TX More articles by this author , Dominic LeeDominic Lee Dallas, TX More articles by this author , Elliot FrohmanElliot Frohman Dallas, TX More articles by this author , and Gary LemackGary Lemack Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2032AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiple Sclerosis (MS) is a demyelinating disorder in which 80% patients will seek urologic care due to bothersome lower urinary tract symptoms. Although urgency and urge incontinence are most frequently reported, the age demographic affected by MS suggests that stress urinary incontinence would be common as well. We report on the prevalence of stress urinary incontinence (SUI) in a large cohort of MS patients referred to a tertiary neurogenic bladder (NGB) clinic. METHODS An IRB-approved neurogenic bladder database of MS patients followed over a 10 year period was queried for urodynamic (UD) and demographic data. Demographic information included MS classification, age at initial visit, BMI and parity. Clinical SUI was defined as the presence of urodynamic stress incontinence using provocative testing (USI) and/or incontinence on supine stress test performed with a comfortably full bladder. Urogenital Distress Inventory Short form (UDI-6) responses were also obtained at the initial visit. RESULTS Between 1/2000-7/2011, 280 women with MS were referred to the tertiary care NGB clinic. Their mean and median age was 50, and mean duration of MS was 13 years (median 2). Relapse remitting MS (RRMS) was noted in 40%, followed by Secondary Progressive MS in 36% and Primary Progressive in 7%. SUI was demonstrated in 39 (14%) of patients. Women with SUI had a higher average Qmax (15 ml/sec vs. 9 ml/sec, p<0.001), higher voided volumes (272 cc vs. 194cc, p=0.02) and a higher BMI (30 vs. 25, p<0.001). There was no difference in age, parity or MS duration when comparing those with and without SUI. When looking at MS classification, patients with RRMS were more likely to have SUI compared to patients with PMS (21 vs. 10, p=0.02). Among women with SUI, total UDI-6 score was higher (6 vs. 3.6, p<0.01), including higher scores on question 3(p<0.001) and 4 (p=0.03). CONCLUSIONS Higher voided volumes and flow rates in those with SUI indicate improved emptying and diminished outlet resistance, as has been reported in non-neurogenic SUI populations. The 14% prevalence of demonstrable SUI in women with MS is markedly lower than published historical data of an age matched cohort without MS. The surprisingly low prevalence of SUI among women with MS may be attributable to diminished activity level, neurogenically enhanced strength of the vesicourethral unit, or other functional or anatomic etiologies which merit further study. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e759 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Dillon Dallas, TX More articles by this author Casey Seideman Dallas, TX More articles by this author Michelle Van Kuiken Dallas, TX More articles by this author Dominic Lee Dallas, TX More articles by this author Elliot Frohman Dallas, TX More articles by this author Gary Lemack Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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