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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Worsening disability status in multiple sclerosis predicts urologic complications
Alejandro Abello1, Jonathan Badin2, Anurag K Das3
1Department of Urology, Yale School of Medicine, New Haven, CT, USA.
International Urology and Nephrology
|January 27, 2020
Summary
Multiple sclerosis (MS) complications are linked to disease progression and disability. Interventions like catheterization increase risks, particularly for lower urinary tract infections.
Area of Science:
- Urology
- Neurology
- Nephrology
Background:
- Multiple sclerosis (MS) is known to cause voiding dysfunction.
- Long-term urologic complications and their risk factors in MS patients remain unclear.
Purpose of the Study:
- To evaluate long-term changes in voiding function in MS patients.
- To identify risk factors for urologic complications during MS follow-up.
Main Methods:
- Retrospective analysis of MS patient records, including voiding symptoms, urodynamics (UDS), and Expanded Disability Status Scale (EDSS).
- Statistical analysis using t-tests, Chi-square tests, Kaplan-Meier curves, and Cox proportional hazard models.
- Assessment of complication-free survival and prediction of complications based on independent variables.
Main Results:
- Over 9.7 years, 60.2% of MS patients experienced at least one urologic complication; 16.7% had major complications.
- Significant risk factors for complications included EDSS progression (≥2.0), high follow-up EDSS (≥6.0), intermittent catheterization, and continent catheterizable stoma.
- Lower tract infections were more frequent in patients requiring catheterization.
Conclusions:
- Major upper tract complications in MS patients are infrequent.
- MS progression, increased disability, and interventions for continence management are associated with urologic complications.
- Catheterization necessitates careful monitoring for lower urinary tract infections.
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