Dérivation urinaire non continente et modes mictionnels alternatifs chez les patients atteints de sclérose en plaques

Abstract

To compare non-continent urinary diversion (NCUD) and other bladder managements in patients with multiple sclerosis (MS), in terms of satisfaction and burden of care. All patients with MS that were proposed a NCUD in our center for refractory lower urinary tract disorders between January 2005 and March 2018 were eligible. Patients were attributed to two distinct groups: "NCUD" and "Other bladder management". The primary endpoint was the satisfaction related to the bladder management quoted by a numerical rating scale (NRS) from 0 to 10. The secondary endpoints included, among other things, the evaluation of the burden of care associated with the bladder management. Twenty-three patients were included in the "NCUD" group and 11 in the "Other bladder management" group, with 4 patients pursuing with spontaneous voiding, 3 with intermittent catheterization, 2 that have undergone a sphincterotomy, 1 still performing self-intermittent catheterization and 1 with a supra-pubic catheter. The "NCUD" group had a significant higher NRS than the "Other bladder management" group (8.22±1.78 vs. 6.27±2.45; P=0.0056). The daily average duration of care was 16.42minutes in the "NCUD" group and 35.6minutes in the "Other bladder management" group (P=0.1111) CONCLUSION: This exploratory study, even if not conclusive, brings to light the preliminary results needed to elaborate a high level of evidence protocol regarding the satisfaction and the burden of care associated with NCUD in MS patients. 4.