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Challenges to Longitudinal Characterization of Lower Urinary Tract Dysfunction in Multiple Sclerosis
Tamara B Kaplan1, Arpita Gopal2, Valerie J Block3
1Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Multiple Sclerosis and Related Disorders
|April 23, 2022
Summary
Lower urinary tract symptoms (LUTS) in people with multiple sclerosis (PwMS) are more common in females and those with progressive MS. Clinicians may under-diagnose LUTS in women.
Area of Science:
- Neurology
- Urology
- Epidemiology
Background:
- Neurogenic lower urinary tract dysfunction (LUTD) causes lower urinary tract symptoms (LUTS) impacting quality of life in people with multiple sclerosis (PwMS).
- Risk factors for LUTD and its role in multiple sclerosis (MS) progression remain under-researched.
Purpose of the Study:
- Identify clinical and demographic predictors of LUTS in PwMS.
- Assess gaps in clinical ascertainment of LUTS in PwMS.
Main Methods:
- Prospective, multicenter study (SUMMIT, N=802) of adults with MS.
- Analysis of demographic, clinical, and reproductive factors associated with bowel/bladder dysfunction.
- Review of medical records to evaluate LUTS ascertainment patterns and contribution to functional scores.
Main Results:
- Higher symptom scores associated with female sex (p=0.001) and progressive MS type (p≤0.001).
- Female reproductive factors (parity, menopause) not significantly linked to worse symptoms.
- LUTS were under-ascertained, particularly in women (p=0.08).
Conclusions:
- Female sex and MS type predict worsening LUTS.
- LUTS may be under-ascertained in females compared to males.
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