Abstract
BackgroundMost patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS.MethodsThis cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS.ResultsThe prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P< 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507–0.903), P = 0.008].ConclusionsA high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.
Highlights
Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease
An overview of the Multiple Sclerosis Association of America (MSAA) showed that 50– 65% of patients with MS had a mild disability and complained of at least one moderate to severe lower urinary tract symptoms (LUTS), and LUTS is the initial symptom of the disease in 2 to 14% of patients with MS
[13] The results of a study revealed that urinary and urodynamic findings of the two sexes are similar, and despite the similarity in their urodynamic findings, patients with relapsingremitting MS (RRMS) reported greater LUTS severity compared to patients with secondary progressive multiple sclerosis (SPMS) [14]
Summary
Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. Several studies have reported that the majority of patients with MS suffer from lower urinary tract symptoms (LUTS), which are among the most common debilitating social manifestations of the disorder, are often ignored [4], and are a major source of morbidity and financial burden for these patients [5]. [13] The results of a study revealed that urinary and urodynamic findings of the two sexes are similar, and despite the similarity in their urodynamic findings, patients with relapsingremitting MS (RRMS) reported greater LUTS severity compared to patients with secondary progressive multiple sclerosis (SPMS) [14]. The urinary incontinence complaint is more prevalent among women and the prevalence of stimulatory complaints such as urgency, diurnal and nocturnal polyuria, and pain is identical between the sexes [12]
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