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First-line urological evaluation in multiple sclerosis: validation of a specific decision-making algorithm.

Gérard Amarenco1, Emmanuel Chartier-Kastler, Pierre Denys

  • 1Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital TENON, APHP, France, GREEN UPMC, GRC 01 UPMC.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 24, 2013
PubMed
Summary

A new algorithm helps neurologists and GPs manage multiple sclerosis urinary issues. The First-Line Urological Evaluation in Multiple Sclerosis (FLUE-MS) tool aids in early detection and treatment, improving patient quality of life.

Keywords:
Algorithmsmultiple sclerosisoveractive bladderurinary incontinenceurinary incontinence – urgeurination disorders

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Area of Science:

  • Neurology
  • Urology
  • Clinical Algorithm Development

Background:

  • Urinary disorders are common in multiple sclerosis (MS), significantly impacting patient quality of life.
  • Current urinary management guidelines for MS are limited and primarily for specialists.

Purpose of the Study:

  • To develop and validate a practical algorithm for neurologists and general practitioners.
  • To facilitate the initial evaluation and treatment of urinary dysfunction in multiple sclerosis patients.

Main Methods:

  • Literature analysis identified 49 items for symptom evaluation and treatment.
  • The Delphi method achieved expert consensus for algorithm development.
  • Validation included two questions from the Urinary Bothersome Questionnaire in Multiple Sclerosis.

Main Results:

  • Consensus on all 49 items was reached after three expert review rounds, finalizing the algorithm.
  • The validated Urinary Bothersome Questionnaire in Multiple Sclerosis questions demonstrated high comprehensiveness (99.7%) and acceptability (99.1%).

Conclusions:

  • The First-Line Urological Evaluation in Multiple Sclerosis (FLUE-MS) algorithm is designed for non-specialists.
  • It assists in identifying critical 'red flags' for timely referral.
  • The algorithm supports appropriate first-line management of urinary issues in MS.