Bladder and urodynamic changes in multiple sclerosis

Hesham Torad,Ahmed Yehia,Shaimaa H Soliman,Hussein Aly Hussein,Samer Morsy,Nevin Shalaby,Mohamed S Abdelazim,Samih Z Sadek

doi:10.1186/s41983-020-00178-z

Abstract

BackgroundUrinary dysfunction is a common symptom during the course of multiple sclerosis (MS). Long-term follow-up of the natural history of bladder dysfunction in MS has been seldom addressed.ObjectiveTo identify the type and the course of voiding dysfunction in MS patients in relation to the urodynamic changes of the lower urinary tract (LUT)Subjects and methodsAn observational prospective study including 120 MS patients with urinary dysfunction rated by the American Urological Association (AUA) symptoms questionnaire and assessed by urodynamic studies and followed for 1 year.ResultsIrritative symptoms were the most frequently encountered symptoms (90%), whereas overactive bladder was recorded by urodynamic studies in 35% of subjects. Urinary symptoms severity score was higher in patients with initial urodynamic abnormalities by the end of the 1-year follow-up period (P < 0.001). A statistically significant relationship was found between urinary symptoms severity score and each of expanded disability status scale (EDSS) and urodynamic pattern of abnormalities (P < 0.01).ConclusionIrritative symptoms and overactive bladder seem to be the most frequent urinary dysfunction in MS patients. Urinary symptoms are related to the degree of disability. The initial urodynamic abnormalities are associated with worse urinary dysfunction outcome after 1 year.

Highlights

Multiple sclerosis (MS) is the most common demyelinating disorder affecting the central nervous system (CNS)
Irritative symptoms were the most frequently encountered symptoms (90%), whereas overactive bladder was recorded by urodynamic studies in 35% of subjects
A statistically significant relationship was found between urinary symptoms severity score and each of expanded disability status scale (EDSS) and urodynamic pattern of abnormalities (P < 0.01)

Summary

Introduction

Multiple sclerosis (MS) is the most common demyelinating disorder affecting the central nervous system (CNS). Lower urinary tract dysfunction (LUTD) in MS patients results from disturbance in the neurological control of the detrusor-sphincter function, leading to detrusor overactivity, detrusor hypocontractility, and detrusor-sphincter dyssynergia (DSD) which can be assessed by urodynamic evaluation to provide a more evident clue to the nature of the dysfunction [3, 4]. Many studies have explored the relation between urinary symptoms in MS patients and objective urological patterns with different outcome [5,6,7] the relation of LUTD, and clinical parameters of multiple sclerosis as disease severity and disease duration [6]. The aim of this study was to identify the type and fate of bladder symptoms in MS patients during and after 1year follow-up in relation to initial urodynamic and clinical disability. Urinary dysfunction is a common symptom during the course of multiple sclerosis (MS). Long-term follow-up of the natural history of bladder dysfunction in MS has been seldom addressed

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Results

Discussion

Conclusion