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Nocturia in Patients With Multiple Sclerosis.

Benoit Peyronnet1,2, Lauren B Krupp3, W Stuart Reynolds4

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Summary
This summary is machine-generated.

Nocturia affects up to 48.8% of multiple sclerosis (MS) patients due to complex neurogenic bladder dysfunction or nocturnal polyuria. Effective management requires tailored treatments addressing underlying causes like detrusor overactivity or autonomic dysfunction.

Keywords:
DesmopressinFatigueMultiple sclerosisNocturiaNocturnal polyuriaVoiding diary

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Area of Science:

  • Neurology
  • Urology
  • Sleep Medicine

Background:

  • Nocturia prevalence in multiple sclerosis (MS) ranges from 20.9% to 48.8%.
  • Pathophysiology differs from non-neurogenic populations, involving neurogenic lower urinary tract dysfunction (NLUTD) and nocturnal polyuria.
  • Nocturia exacerbates fatigue and may link to sleep disorders in MS patients.

Purpose of the Study:

  • To review the complex pathophysiology of nocturia in MS patients.
  • To outline diagnostic approaches for nocturia in MS.
  • To discuss tailored treatment strategies for nocturia in MS.

Main Methods:

  • Comprehensive literature review focusing on nocturia in MS.
  • Analysis of underlying mechanisms including NLUTD and nocturnal polyuria.
  • Summary of diagnostic tools: history, physical exam, urinalysis, frequency-volume charts, post-void residual, urodynamics, polysomnography.

Main Results:

  • Nocturia in MS can stem from detrusor overactivity, detrusor-sphincter dyssynergia, or detrusor underactivity.
  • Nocturnal polyuria mechanisms include autonomic dysfunction and altered antidiuretic hormone (ADH) production.
  • Assessment guides tailored treatments: behavioral, pharmacological (antimuscarinics, beta-3 agonists, desmopressin), or procedural (botulinum toxin, catheterization).

Conclusions:

  • Nocturia is a significant, complex issue in MS with multifactorial causes.
  • Personalized treatment based on identified mechanisms is crucial for managing MS-related nocturia.
  • Further research is needed on the interplay between nocturia, sleep, and fatigue in MS.