Expert opinion consensus document: management of bladder dysfunction in people with multiple sclerosis.

Area of Science:

• Neurology
• Urology
• Public Health

Background:

• Neurogenic bladder increases UTI risk in people with multiple sclerosis (PwMS), leading to hospital admissions and significant healthcare costs.
• The last UK consensus on multiple sclerosis (MS) bladder management was published in 2009, necessitating an update.
• Urinary dysfunction is a common and burdensome complication for PwMS.

Purpose of the Study:

• To provide updated, evidence-based recommendations for the assessment and management of lower urinary tract dysfunction in PwMS.
• To offer guidance on first- and second-line treatments for impaired voiding and medications for overactive bladder symptoms.
• To promote patient self-management strategies, including home testing and patient-initiated follow-up.

Main Methods:

• A consensus panel meeting with multidisciplinary membership, including individuals with lived experience.
• A comprehensive literature search to inform evidence-based recommendations.
• Development of new guidance based on expert discussion and current evidence.

Main Results:

• New recommendations for assessing lower urinary tract issues in PwMS.
• Updated guidance on pharmacological and non-pharmacological treatments for voiding dysfunction and overactive bladder.
• Emphasis on patient self-management and the potential for a national bladder pathway.

Conclusions:

• The updated guidance addresses critical needs in managing bladder dysfunction in PwMS.
• A national bladder pathway for PwMS is a key recommendation to improve care coordination.
• Empowering patients through self-management is crucial for optimizing outcomes.