Protocolo de tratamiento de la disfunción del tracto urinario inferior en la esclerosis múltiple y trastornos relacionados

Abstract

Lower urinary tract dysfunction (LUTD) affects between a third and the majority of patients with multiple sclerosis, its prevalence increasing with the duration of the disease and causing a great impact on quality of life. LUTD is classified into filling symptoms, voiding symptoms, or mixed symptoms. The scenario of simultaneous contraction of the detrusor and bladder sphincter is called bladder detrusor sphincter dyssynergia and requires periodic ultrasound and renal function monitoring, due to the risk of kidney impairment caused by a retrograde increase in pressure. Filling symptoms are treated with hygienic-dietary measures, antimuscarinics, mirabegron, desmopressin, botulinum toxin or neuromodulation. Symptoms of voiding (postvoid residue greater than 100mL) are treated with intermittent self-catheterization or, less commonly, indwelling bladder or suprapubic catheterization.