[Bladder, bowel and sexual dysfunction in patient with mulitple sclerosis]

Bladder, bowel and sexual dysfunction are not rare in multiple sclerosis (MS). The most frequent bladder disorders are in urgency, frequency as well as retention. In this study we analyzed bladder dysfunction (urgency, frequency and retention), defecation (constipation and incontinence) as well as sexual problems (libido, erection and vaginal lubrication) in patients with relapsing-remitting form of multiple sclerosis (MS) depending on disability status. Concerning Expanded Diasability Status Score (EDSS), patients have been divided in two groups: EDSS 0-4.5. (Group A), and EDSS 5.0-10.0 (group B). We analyzed 60 patients: 35 (58.3%) women, and 25 (41.7%) men. In both group A and B, with no bladder disorder was 18 patients (30%). In group A: 15 (25%); in group B: 3 (5%). With urgent incontinence were 36 (60%) patients - group A: 19 (31%); group B: 17 (28%). With retention were 6 (10%) patients - group A: 4 (6.6%); group B: 2 (3.3%). There is no statistical significant difference in number of patients with and with no urinary problems in both groups (p>0.05). Of all analyzed patients in group A and B with no urinary disorders were 9 men (15%) and 9 women (15%). With urinary problems were 16 men (26.7%) and 26 women (43.3%). Statistically it is significant higher number of women than men (p<0.05). With no defecation problems were 54 (90%) patients - in group A: 36 (60%); in group B: 18 (30%). With constipation were 5 (8.3%) - in group A: 2 (3.3%); in group B 3 (5%). In group B one patient (1.6%) had incontinence. There is no statistical significant difference in number of patients with and with no bowel elimination dysfunction in both groups p>0.05). 12 (20%) men had no bowel elimination problems and 24 women (40%), but 10 (16.6%) men and 8 (13.3%) women had the bowel elimination dysfunction. There is no statistical significance (p>0.05). No libido disturbance had 44 (73.3%) patients. In the group A: 35 (58.3%); in group B: 9 (15%). 16 (26.7%) patients had the libido disturbances. In group A: 3 (5%); in group B 13 (21.6%). Statistically there is significant lower number of patients with libido problems in group A (p<0.05). No vaginal lubrication had 21 (35%) women. In group A: 18 (30%); in group B 3 (5%). Vaginal lubrication disturbance had 14 (23.3%). In group A: 7 (11.6%); in group B 7 (11.6%). Statistically it is significant lower number of women with no lubrication in group B (p<0.05). No erection problems had 11 (18.3%) men. In group A: 9 (15%); in group B 2 (3.3%). Erection disturbance had 14 (23.3%). In group A: 4 (6.6%); in group B: 10 (16.6%). There is statistical significant lower number of men with erection problems in group A. (p<0.05). Of all analyzed patients in both groups A and B 18 men (30%) and 26 (43%) women had no problems with libido and 7 (11.6%) men and 9 (15%) women had the problems. There is no statistical significance in sex distribution (p>0.05). 11 (18.3%) men had no erection problems, 14 (23.3%) had the problems. 21 (35%) women had no vaginal lubrication problems, 14 (23.3%) women had the problems. Erection disturbances are not statistically significant to vaginal lubrication problems (p>0.05).