PD04-04 ELEVATED POST-VOID RESIDUAL DOES NOT PREDICT WORSENING UROLOGIC SYMPTOMS IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2018PD04-04 ELEVATED POST-VOID RESIDUAL DOES NOT PREDICT WORSENING UROLOGIC SYMPTOMS IN PATIENTS WITH MULTIPLE SCLEROSIS Elizabeth Dray, John Stoffel, J Quentin Clemens, Anne Pelletier Cameron, Priyanka Gupta, Paholo Barboglio-Romo, Diana Covalschi, and Yongmei Qin Elizabeth DrayElizabeth Dray More articles by this author , John StoffelJohn Stoffel More articles by this author , J Quentin ClemensJ Quentin Clemens More articles by this author , Anne Pelletier CameronAnne Pelletier Cameron More articles by this author , Priyanka GuptaPriyanka Gupta More articles by this author , Paholo Barboglio-RomoPaholo Barboglio-Romo More articles by this author , Diana CovalschiDiana Covalschi More articles by this author , and Yongmei QinYongmei Qin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.282AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The majority of patients with multiple sclerosis (MS) experience at least one moderate to severe urinary complaint and many MS patients also experience some degree of urinary retention. Our goal was to study how post-void residual (PVR) values impacted urinary symptoms in MS patients. METHODS We performed an IRB approved retrospective review of MS patients with lower urinary tract symptoms (LUTS) presenting to a tertiary neurourology clinic. Patients who had a PVR recorded at their urologic assessment were included in our analysis. The American Urological Association Symptom Score (AUA-SS), and the Michigan Incontinence Symptom Index (M-ISI) were administered at the visit when PVR was measured to assess obstructive LUTS and incontinence symptoms respectively, as well as overall urinary quality of life. Chart review was performed for demographic information. RESULTS Between 2014 and 2017, 104 unique patients with a diagnosis of MS underwent ultrasound or catheterized PVR measurement in our clinic. Average patient age was 56 years (range 29-82), 70% of patients were female and 84% were Caucasian. Relapsing-remitting MS was the most common type of disease (53%) followed by secondary-progressive (36%). Recurrent UTIs were reported in 26% of patients and 7.7% voided but performed occasional intermittent self-catheterization. The average post-void residual was 123.4ml (range 0-650cc). Mean AUA score was 19.1 with an average bother score of 4.1. Analysis of PVR as a continuous variable did not show an association between increasing PVR and increasing AUA SS or bother score (p=0.53 and 0.44 respectively). PVR tertiles for the cohort were <50ml (n=39), 50-150ml (n=30), greater than 150 (n=35). Average AUA SS by increasing PVR group was 18.0, 20.1, 19.7, AUA bother score was 4.2, 4.3, 4.0 and M-ISI score was 13.7, 12.7, 14.9. No relationship between AUA SS or M-ISI and PVR tertile was demonstrated (p=0.54, 0.57), and no correlation was found between increasing PVR and recent history of recurrent UTIs (p=0.55). On a multivariate analysis which examined potential relationships between urinary symptom scores and the variables PVR, gender, anticholinergic and disease modifying medication use, duration and type of MS, an increasing PVR was not associated with increasing AUA SS or M-ISI scores (p=0.84, 0.18). CONCLUSIONS Elevated post-void residual was not associated with worsening obstructive LUTS as assessed by AUA SS, worsening incontinence as measured by M-ISI score or increased risk of recurrent UTIs in selected MS patients with LUTS. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e78-e79 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Elizabeth Dray More articles by this author John Stoffel More articles by this author J Quentin Clemens More articles by this author Anne Pelletier Cameron More articles by this author Priyanka Gupta More articles by this author Paholo Barboglio-Romo More articles by this author Diana Covalschi More articles by this author Yongmei Qin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...