Renal deterioration in multiple sclerosis patients with neurovesical dysfunction.

Area of Science:

• Nephrology
• Neurology
• Urology

Background:

• Multiple sclerosis (MS) patients often experience lower urinary tract symptoms (LUTS).
• The impact of LUTS and MS on upper urinary tract (UUT) health requires further investigation.
• Renal ultrasound (RUS) is a key imaging modality for assessing UUT structure.

Purpose of the Study:

• To determine the prevalence and incidence of renal ultrasound (RUS) abnormalities over time in multiple sclerosis (MS) patients presenting with lower urinary tract symptoms (LUTS).
• To identify potential risk factors, including urodynamic parameters and patient demographics, associated with the development of UUT abnormalities in this cohort.

Main Methods:

• Retrospective analysis of data from MS patients with LUTS between 2000-2009.
• Inclusion criteria: baseline urodynamics (UD) and RUS, with follow-up RUS at ≥12 months.
• Evaluation of age, time since diagnosis, MS subtype, and UD/RUS results for associations with UUT abnormalities.

Main Results:

• Initial RUS abnormalities were present in 5.8% of 173 subjects; 12.4% of 89 subjects with follow-up RUS developed UUT abnormalities.
• Older age (>49 years) and abnormal bladder compliance were significantly associated with increased risk of UUT abnormalities.
• No other demographic or urodynamic factors demonstrated a significant association with RUS abnormalities.

Conclusions:

• The development of structural upper urinary tract changes is infrequent in multiple sclerosis patients with LUTS.
• Urodynamic studies are valuable for guiding LUTS management strategies in MS patients.
• Urodynamics does not appear to significantly impact or predict the occurrence of upper tract changes in this population.