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The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
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Renal deterioration in multiple sclerosis patients with neurovesical dysfunction.

Sophie G Fletcher1, Benjamin E Dillon, Alienor S Gilchrist

  • 1Department of Urology, The Methodist Hospital, Houston, TX 77030, USA. sgfletcher@tmhs.org

Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 23, 2013
PubMed
Summary

Renal ultrasound abnormalities are uncommon in multiple sclerosis patients with lower urinary tract symptoms. While urodynamics aids LUTS management, it doesn't significantly predict upper tract changes.

Keywords:
Neurogenic bladderlower urinary tractmultiple sclerosisupper urinary tracturodynamicsurological symptoms

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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.