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Urogenital dysfunction in patients with multiple sclerosis.

David B Vodušek1

  • 1Division of Neurology, University Medical Centre, Ljubljana, Slovenia.

Acta Neuropsychiatrica
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Summary
This summary is machine-generated.

Urogenital dysfunction, including urinary and sexual issues, is common in multiple sclerosis (MS) patients, significantly impacting quality of life. Early diagnosis and management by MS centers can improve patient outcomes.

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Area of Science:

  • Neurology
  • Urology
  • Sexual Medicine

Background:

  • Urogenital dysfunction is rare as an early symptom of multiple sclerosis (MS) but prevalent in advanced stages.
  • Lower urinary tract dysfunction can contribute to mortality via infections and significantly reduces patient quality of life.

Purpose of the Study:

  • To outline diagnostic and management strategies for urogenital dysfunction in multiple sclerosis patients.
  • To emphasize the importance of early intervention and multidisciplinary care for urinary and sexual issues in MS.

Main Methods:

  • Initial diagnosis by neurologists and specialized nurses in MS centers, including history, urine tests, and post-void residual urine measurement (ultrasound preferred).
  • Urodynamic testing for functional diagnosis of bladder storage and evacuation issues.
  • Clinical examination to assess MS-related deficits relevant to sexual counseling.

Main Results:

  • First-line management includes treating infections, bladder training, anticholinergics, and intermittent self-catheterization.
  • Referral to urology is reserved for patients unresponsive to initial treatment.
  • Sildenafil shows efficacy in men but not women for sexual dysfunction; other management options are available.

Conclusions:

  • MS patients require proactive screening and management for urogenital dysfunction.
  • Suprapubic catheterization is preferred for bladder emptying in late-stage MS.
  • MS centers should provide first-line counseling and management for both urinary and sexual dysfunction.