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

The neurogenic bladder is associated with an increased risk of urinary tract infection (UTI), which is a leading cause of hospital admission in people with multiple sclerosis (PwMS) and thus imposes a significant health economic burden on the NHS. The last UK consensus document on the management of the bladder in multiple sclerosis (MS) was published in 2009. This document, based on a consensus panel meeting discussion and literature search, updates that guidance. It presents new, evidence-based recommendations relating to the assessment of the lower urinary tract in PwMS, first- and second-line treatments of impaired voiding, and medications for overactive bladder symptoms. There is also guidance on how to promote patient self-management, including the use of home testing kits and patient-initiated follow-up. A key recommendation is the need for a national bladder pathway for PwMS. The consensus panel had a multidisciplinary membership and included two PwMS with first-hand experience of bladder problems.