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Published on: August 28, 2020
The neurogenic bladder characteristics and treatment approaches in the patients with multiple sclerosis
Ender Erden1, Murat Ersöz2, Tülay Tiftik3
1The Department of Physical Medicine and Rehabilitation, Hitit University School of Medicine, Çorum, Turkey.
Objectives:
To analyze the neurogenic bladder characteristics and the treatment approaches in patients with multiple sclerosis (MS) to facilitate proper and reasonable decisions in relevant patients.
Design:
Retrospective study.
Setting:
Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey.
Participants:
Seventy-five patients diagnosed with MS between 2002 and 2015 were included in the study.
Intervention:
Urodynamic examination.
Outcome Measure:
The detrusor type, detrusor compliance, sense of bladder fullness, storage disorder, emptying disorder, voided volume, post-void residual volume, urine culture, emptying method, and medical treatments were recorded.
Results:
The study included 53 females and 22 males with a mean age of 36 ± 10.1 years. Urodynamic examinations indicated that 74.7% of the patients had detrusor overactivity, 74.7% had detrusor hypocompliance, 77.3% had storage dysfunction, and 81.3% had emptying dysfunction. An anticholinergic medication was recommended to 74.7% of the patients, while alpha-adrenergic receptor blockers were recommended to 69.3%. The detrusor hypocompliance was more common in the group with a disease duration of ≥10 years (p = 0.045). The use of external collector systems was more common, and urine culture was more frequently positive for infections in the female patients (p = 0.001 and p = 0.049, respectively). The frequency of normal bladder-filling sensation was higher in women (p = 0.01). The frequencies of detrusor overactivity and storage and emptying disorders, voided and postvoid volumes (mL), and bladder emptying methods were not significantly different among the subgroups (p > 0.05).
Conclusion:
The study revealed a significant neurogenic bladder dysfunction and an inadequate management of this dysfunction in MS patients. Considering that the symptoms may progress over time, the urinary systems of MS patients should be evaluated periodically, and necessary modifications should be made in their treatments.
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