Vesicourethral dysfunction in multiple sclerosis. Initial assessment based on lower urinary tract symptoms and their...

Area of Science:

• Neurology
• Urology
• Clinical Medicine

Background:

• Multiple sclerosis (MS) commonly causes lower urinary tract symptoms (LUTS).
• LUTS in MS can be classified as irritative, obstructive, or mixed.
• Lesion location and bladder dysfunction correlate with LUTS type.

Purpose of the Study:

• To review the common types of LUTS in multiple sclerosis (MS).
• To correlate LUTS with lesion location and underlying bladder pathophysiology.
• To highlight management strategies for MS-related LUTS.

Main Methods:

• Review of existing literature on LUTS in MS.
• Correlation of symptom presentation with neurological lesion sites.
• Association of LUTS with urodynamic findings like detrusor overactivity or sphincter dyssynergia.

Main Results:

• Irritative LUTS are common with cortical, brainstem, or mild spinal cord lesions.
• Obstructive LUTS frequently occur with spinal cord lesions below the pontine micturition center or sacral lesions.
• Irritative LUTS often relate to detrusor overactivity; obstructive LUTS to detrusor sphincter dyssynergia or areflexia.

Conclusions:

• Understanding the relationship between lesion location and LUTS type is crucial for MS patient management.
• Management of MS-related LUTS can often follow established clinical algorithms.
• International guidelines provide a framework for effective LUTS management in MS.