Clinical Predictors of Neurogenic Lower Urinary Tract Dysfunction in Persons with Multiple Sclerosis

Area of Science:

• Neurology
• Urology

Background:

• Multiple sclerosis (MS) frequently causes neurogenic lower urinary tract dysfunction (NLUTD).
• NLUTD poses a risk for upper urinary tract damage.
• Current diagnostic recommendations for NLUTD in MS are debated.

Purpose of the Study:

• To identify clinical indicators of NLUTD in MS patients.
• To correlate clinical parameters with urodynamic findings in MS.

Main Methods:

• Prospective assessment of 207 MS patients, irrespective of lower urinary tract symptoms.
• Analysis of Expanded Disability Status Scale (EDSS), uroflowmetry, post-void residual (PVR), UTI rates, voiding frequency, and voided volume against urodynamic data.

Main Results:

• Significant correlations found between NLUTD and PVR, UTI rate, voided volume, and voiding frequency.
• EDSS scores did not correlate with NLUTD.
• Increased voiding frequency, UTI rate, and reduced voided volume correlated with reduced bladder compliance and potential kidney damage risk.

Conclusions:

• Bladder diary and UTI rate are valuable for identifying MS patients needing urodynamic evaluation.
• Routine assessment of these parameters can aid in early detection and management of NLUTD.