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Vesicourethral dysfunction associated with multiple sclerosis: clinical and urodynamic perspectives

G A Barbalias1, G Nikiforidis, E N Liatsikos

  • 1Department of Urology, University of Patras, School of Medicine, Greece.

The Journal of Urology
|June 17, 1998
PubMed
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Clinical and urodynamic findings in multiple sclerosis (MS) can predict disease severity. Identifying bladder and sphincter issues prevents complications and improves quality of life for MS patients.

Area of Science:

  • Urology
  • Neurology
  • Clinical Medicine

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease affecting the central nervous system.
  • Bladder dysfunction is a common and often debilitating symptom in MS patients.
  • Understanding the relationship between clinical presentation and urodynamic findings is crucial for managing MS-related bladder issues.

Purpose of the Study:

  • To investigate the association between clinical and urodynamic findings in multiple sclerosis (MS).
  • To identify potential predictors of clinical grade in MS patients.
  • To correlate urodynamic parameters with the severity of MS.

Main Methods:

  • A prospective study of 90 MS patients (aged 28-62) was conducted.
  • Detailed video urodynamic evaluation and electromyography of the external urethral sphincter were performed.

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  • Statistical analysis compared patients with less severe (grades 1-2) versus more severe (grade 3) MS.

    • Main Results:

    • Urodynamic findings included detrusor hyperreflexia (57.7%), detrusor external sphincter dyssynergia (30%), and detrusor hypocontractility/areflexia (16.6%).
    • Significant differences between MS grades were observed in incontinence, high post-void residual, leg spasticity, urinary stones, hydronephrosis, type 3 detrusor external sphincter dyssynergia, and electromyography findings.
    • Urinary stones, sepsis, type 3 detrusor external sphincter dyssynergia, and absent external urethral sphincter electromyography activity were highly predictive (100%) of more severe MS.

    Conclusions:

    • Accurate assessment of bladder and external urethral sphincter function is vital in MS management.
    • Excluding detrusor overactivity or dyssynergic responses can prevent serious complications.
    • Early identification and management of these urodynamic abnormalities can significantly improve patients' quality of life.