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Vesicourethral dysfunction and urodynamic findings in multiple sclerosis: a study of 149 cases
P Gallien1, S Robineau, B Nicolas
1Clinique de Rééducation Fonctionelle, Centre Hospitalier et Universitaire de Rennes, Hôpital Pontchaillou, France.
Objective:
Vesicourethral dysfunction is common in people with multiple sclerosis and results in significant impairment. We studied the clinical and urodynamic findings in such patients to define risk factors for incontinence and upper urinary tract infections.
Design And Setting:
A cohort study of 149 patients with multiple sclerosis and urinary symptoms seen in our urodynamic laboratory.
Intervention:
A complete urodynamic study of each patient with urethrocystometry and continuous recording of the urethral sphincter electromyography and assessment of postvoid residual.
Results:
Detrusor hyperreflexia and sphincter dyssynergia were the main dysfunctions. No significant relation between clinical features and urodynamic patterns was found. Women with low maximal urethral pressure were particularly prone to incontinence, which occurred in 69% of the patients. Pyelonephritis was associated with a postvoiding residual urine of > 30% of the functional detrusor capacity, and was found more often in the male population.
Conclusion:
Urodynamic assessment of bladder function is critical to direct therapy for urinary complaints in people with multiple sclerosis.