Vesical dysfunction in multiple sclerosis

Sixty-four patients with multiple sclerosis and associated symptoms of neurogenic bladder dysfunction underwent urodynamic evaluation. The most common symptoms were urgency, incontinence, and frequency which did not correlate with urodynamic findings. Cystometrography demonstrated hyperreflexic bladders in 78 per cent and areflexic bladders in 20 per cent of patients. In those patients with hyperreflexia, voiding cystourethrography revealed poorly sustained uninhibited contractions associated with ineffective bladder emptying in 50 per cent, well-sustained contractions in 38 per cent, and detrusor-sphincter dyssynergia in 12 per cent. Therapy consisted of intermittent catheterization, pharmacologic manipulation, or transurethral resection of the external sphincter, according to urodynamic evaluation.