Multipl Skleroz Hastalarında Ürolojik Semptom Sıklığının Hastalık Progresyonu İle İlişkisinin Değerlendirilmesi

Abstract

Purpose : Our aim is to determine the relationship between Multiple Sclerosis (MS) disease progression and urological symptoms Method: We enrolled patients with Newly Diagnosed MS (n: 11), RRMS (n: 9), SPMS (n:6) and healthy control subjects (n:10). Neurological examination was done in all groups. Furthermore patient groups were evaluated with EDSS (Expanded Disability Status Scale) and MSFC (functional capacity in multiple sclerosis scale). Routine blood biochemistry were done. All patients and the subjects in the control group were evaluated in regard to lower urinary tract symptoms by the following questionnaires: incontinence and sexual function in terms of IPSS (International Prostate Symptom Score), ICIQ -SF (International Incontinence Questionnaire), IIEF (International Index of Erectile Dysfunction Test) and FSFI (Female Sexual Function Index). In addition all the patients were evaluated by urodynamic studies in order to examine the voiding function. Results : There were no differences between the group in respect to age, years of education and gender. As the disease duration increase, the frequency of incontinence was found to increase. PSS, IPSS-QOL, ICIQ-SF scores of newly diagnosed MS, RRMS, SPMS and healthy control groups were statistically significant. There was a correlation between EDSS score and urological symptoms. There was no relationship between disease duration and urological symptoms. Due to inadequate number of male patients in the study, IIEF score did not differ significantly between the groups. There was no relationship between EDSS score, disease duration and IIEF .Due to inadequate number of the female patients in the study, FSFI score did not differ significantly between the groups. There was no relationship between EDSS score, disease duration and FSFI. The most attractive result of our study is the urodynamic detrusor overactivity (DO) .Bladder capacity was found to be low in SPMS. EDSS score and 25 step walk score increases while bladder capacity has been reduced. There was no relationship shown between duration of disease and bladder capacity. Conclusion: Patients with Multiple Sclerosis (MS) have a very high prevalence of lower urinary tract symptoms. These symptoms have a great impact on patient quality of life. Therefore early recognition and treatment is an important step in care of MS patients