Lower urinary tract symptoms in women with multiple sclerosis: 2

Bladder dysfunction in women with multiple sclerosis (MS) is a common and distressing problem affecting up to 75% of patients (Das Gupta and Fowler, 2003). It can seriously affect their quality of life and in some cases cause deterioration of MS symptoms. The first part of this article (Rantell, 2009) set out how to perform a full assessment of these patients and how to diagnose their lower urinary tract symptoms (LUTS). This second article aims to provide an overview of the conservative, pharmacological and surgical management of lower urinary tract symptoms. Often women will need a combination of therapies to achieve optimum benefit from treatment. Management and interventions should be regularly re-assessed as women's symptoms and their severity may change over time as the disease progresses.