Epidemiology and characteristics of urinary tract dysfunction in multiple sclerosis patients

Abstract

Introduction. Data on the epidemiology and nature of neurogenic lower urinary tract dysfunction (NLUTD) in multiple sclerosis (MS) are contradictory: the prevalence rate ranges from 50 to 90% according to different authors.Purpose of the study. To assess the frequency and nature of urination disorders in patients with various forms of multiple sclerosis.Materials and methods. We analyzed the data of patients observed in the Regional Centre of Multiple sclerosis at Sverdlovsk Regional Clinical Hospital No. 1. The study included 160 patients aged 42.6±12.3 years, of which 64% were men and 36% were women. The primary progressive course of the disease occurred in 5% of patients, the secondary progressive course in 39%, and remitting in 56%. The average score according to the Expanded Disability Status Scale (EDSS) was 3.94±2.10. The nature of neurogenic dysfunction of the lower urinary tract was evaluated using questionnaires (NBSS, SF-Qualiveen) and urodynamic studies.Results. NLUTD were detected in 65% of MS patients. The average score according to the Neurogenic Bladder Symptom Scale (NBSS) in patients with NLUTD was 26.93±13.12, which was significantly (p < 0.001) exceed than the value of this indicator among patients without pelvic disorders (6.43±2.34). Symptoms of emptying were noted in more than half of patients with a neurogenic bladder in the presence of multiple sclerosis: poor urine flow (63%), abdominal straining during urination (76%). Complaints of storage symptoms, such as urgency and frequency, were presented by 98% of patients with neurogenic lower urinary tract dysfunction. Urinary incontinence was diagnosed in 84% of cases. The values of the «incontinence», «storage and voiding» and «complications» domains of NBSS were 8.66±7.17, 12.18±3.7 and 3.48±4.21, respectively. The total score of SF-Qaliveen questionnaire in patients with MS with urinary disorders was 2.93±1.13, in patients without NLUTD, 1.03±0.91 (р < 0,001).Conclusions. Neurogenic lower urinary tract dysfunction occurs in patients with multiple sclerosis with a frequency of 65%. These urinary disorders have a significant impact on the patients` quality of life.