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[Vesico-sphinteral disorders in multiple sclerosis: value of urodynamic tests]
B Delepaul1, C Saussine, D Jacqmin
1Service de Chirurgie Urologique, Hôpitaux Universitaires de Strasbourg.
Summary
Vesicosphincteric disorders, common in multiple sclerosis, present with urgency and incontinence. Urodynamic studies are crucial for accurate diagnosis and timely treatment to prevent kidney damage.
Area of Science:
- Neurology
- Urology
Context:
- Vesicosphincteric disorders are prevalent in multiple sclerosis (MS).
- These symptoms contribute to MS diagnosis in 2-5% of cases.
- Clinical signs include urgency, frequency, and incontinence due to bladder disinhibition.
Purpose:
- To highlight the frequency and clinical presentation of vesicosphincteric disorders in MS.
- To emphasize the role of urodynamic studies in diagnosing and managing these conditions.
- To underscore the importance of early treatment for preventing upper tract damage.
Summary:
- Urgency (60-80%) and frequency (40-60%) dominate clinical signs, with incontinence common.
- Dysuria (15-30%) can indicate an areflexive or hyperactive bladder with vesicosphincteric dyssynergia.
- Cystomanometry reveals detrusor hyperactivity (50-78%) or hypoactivity (20-40%), with frequent dyssynergia (50-80%).
- No direct correlation exists between clinical and urodynamic findings.
Impact:
- Urodynamic studies are essential for precise urological diagnosis in MS patients.
- Tailored and early treatment is vital to mitigate the long-term risk of upper urinary tract damage.
- Understanding these disorders improves patient management and outcomes in multiple sclerosis care.