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Neurourologic abnormalities in multiple sclerosis

I Goldstein, M B Siroky, D S Sax

    The Journal of Urology
    |September 1, 1982
    PubMed
    Summary
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    Multiple sclerosis frequently causes urinary and sexual dysfunction. Neurourologic testing, including cystometry and electromyography, identifies specific patterns like detrusor hyperreflexia and vesico-sphincter dyssynergia, aiding diagnosis and treatment.

    Area of Science:

    • Neurology
    • Urology
    • Neuroscience

    Background:

    • Multiple sclerosis (MS) is a central nervous system demyelinating disease.
    • MS commonly leads to sexual and urinary control abnormalities.
    • Neurourologic symptoms are prevalent in MS patients.

    Purpose of the Study:

    • To evaluate neurourologic patterns in multiple sclerosis patients.
    • To correlate neurourologic findings with clinical symptoms.
    • To assess the diagnostic and therapeutic significance of neurourologic testing in MS.

    Main Methods:

    • Neurourologic evaluation of 86 MS patients (45 women, 41 men).
    • Utilized rapid-fill carbon dioxide cystometry and perineal floor needle electromyography.
    • Included sacral-evoked responses for occult sacral cord pathology identification.

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    Main Results:

    • Symptomatic voiding dysfunction in 97% of patients.
    • Sexual dysfunction in 71% of men.
    • Common findings: detrusor hyperreflexia (76%) and vesico-sphincter dyssynergia (50%).
    • Bilateral extensor plantar reflexes suggested vesico-sphincter dyssynergia.
    • Sacral-evoked responses aided in identifying sacral cord pathology.
    • Multilevel spinal cord dysfunction suggested by combined abnormal EMG, sacral latency, and detrusor hyperreflexia.

    Conclusions:

    • Neurourologic testing is valuable for identifying lesions, characterizing dysfunction, and guiding treatment in MS.
    • Findings can corroborate diagnoses and aid in planning rational therapeutic strategies.
    • Neurourologic patterns can change over time, necessitating re-evaluation.