[Vesico-sphinteral disorders in multiple sclerosis: value of urodynamic tests]

Vesicosphincteric disorders are frequent in multiple sclerosis and lead to the diagnosis of this disease in 2 to 5% of cases. The clinical signs are dominated by urgency (60 to 80%), frequency (40 to 60%) and incontinence due to vesical disinhibition. Dysuria (15 to 30%) occurs in an areflexive or hyperactive bladder, associated with vesicosphincteric dyssnergia. These signs are frequently associated (50 to 80%). Cystomanometry shows detrusor hyperactivity in 50 to 78% of cases and hypoactivity in 20 to 40% of cases and dyssnergia is frequent (50 to 80%). There is no correlation between the clinical and urodynamic signs. Consequently, urodynamic studies are useful for establishing a precise urological diagnosis and to prescribe adapted and early treatment due to the long-term risk of upper tract damage.