PR_172: Bladder and Sphincter Behavior in Multiple Sclerosis Subjects: A Case Series

Abstract

Setting: Urodynamics and pelvic floor rehabilitation center. Patients: Clinical and urodynamic assessment in subjects with multiple sclerosis (MS). Case Descriptions: Micturitional and neurologic clinical assessment, and urodynamic studies—following International Continence Society recommendations—were performed in a case series of 119 consecutive subjects with MS (45 men, 74 women), focusing on onset of illness, onset, and type of lower urinary tract symptoms (LUTS), age, sex, presence of neurogenic detrusor overactivity or acontractile detrusor, and presence of detrusor sphincter dyssynergia. Assessment/Results: We found normal bladder activity in 32 subjects (26.9%), neurogenic detrusor overactivity in 40 (33.6%), detrusor sphincter dyssynergia in 25 (21%), reduced bladder compliance in 7 (5.9%), and acontractile detrusor in 15 (12.6%). Discussion: Our aim was to determine the incidence of bladder and sphincter dysfunction in subjects with MS, as well as to identify any correlation between illness duration and bladder behavior. The presence of neurogenic detrusor overactivity—as assessed by urodynamics—correlated with longer illness duration (2-tailed t test, P=.039). No constant correlation was found among illness duration, age, sex, and overactive bladder symptoms or other LUTS. 31 (26%) of the 119 subjects showed normal bladder activity. 4 (36%) of the 11 subjects with recently diagnosed MS (<1y) showed normal bladder activity. Conclusions: The presence and type of LUTS are not surely predictive of the underlying bladder and sphincter function in MS. Though we found a correlation between detrusor overactivity—as assessed by urodynamics—and illness duration, age of subject and illness duration were not constantly related to overactive bladder symptoms or other LUTS.