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Therapy Insight: bladder dysfunction associated with multiple sclerosis.

Vinay Kalsi1, Clare J Fowler

  • 1National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Nature Clinical Practice. Urology
|February 14, 2006
PubMed
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Multiple sclerosis (MS) frequently causes bladder dysfunction, impacting patient disability. Effective medical treatments, including anticholinergics and catheterization, manage these troublesome symptoms, reducing reliance on surgery.

Area of Science:

  • Neuroscience
  • Urology
  • Neurology

Background:

  • Bladder dysfunction is a prevalent and debilitating symptom in multiple sclerosis (MS).
  • Symptom severity often correlates with spinal cord lesion load and overall neurological disability.
  • Management is increasingly non-urological and medically focused.

Purpose of the Study:

  • To provide an overview of the neural control of the bladder.
  • To explain the pathophysiology of detrusor overactivity in neurological disease.
  • To review current and emerging medical treatments for MS-related bladder dysfunction.

Main Methods:

  • Review of the neural control of bladder function.
  • Explanation of detrusor overactivity pathophysiology in MS.

Related Experiment Videos

  • Comprehensive review of medical and surgical treatment options for MS bladder dysfunction.

    • Main Results:

    • Medical management is the primary approach, with effective first-line options including anticholinergics, clean intermittent self-catheterization, and desmopressin.
    • Potential second-line treatments encompass cannabinoids, intravesical vanilloids, and intradetrusor botulinum neurotoxin type A.
    • The role of surgical interventions is diminishing.

    Conclusions:

    • Bladder dysfunction in MS is manageable with various medical therapies.
    • Non-surgical treatments offer significant relief from bothersome symptoms.
    • Understanding bladder pathophysiology guides effective therapeutic strategies in MS patients.