Urodynamics in the evaluation of the patient with multiple sclerosis: when are they helpful and how do we use them?

Multiple sclerosis (MS) is an autoimmune inflammatory disease that results in damage to the myelin sheaths of the nerves in the central nervous system. Urinary urgency, frequency, and urgency incontinence are the most common symptoms, occurring in 37% to 99% of patients. Voiding symptoms (hesitancy, feeling of incomplete bladder emptying, and occasionally urinary retention) are also common in this population, occurring in 34% to 79% of patients. Traditionally, filling cystometry combined with pressure/flow studies has been a cornerstone of the initial evaluation of all patients with neurogenic lower urinary tract dysfunction, although recently that practice has been challenged.