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Documento de consenso de expertos: tratamiento de la disfunción de la vejiga en personas con esclerosis múltiple
Sue Thomas1, Joan Bradley2, Trishna Bharadia3
1Independent Healthcare Consultant.
British journal of nursing (Mark Allen Publishing)
|September 4, 2025
Resumen
Las personas con esclerosis múltiple (EMP) enfrentan un mayor riesgo de infecciones del tracto urinario (ITU) debido a la vejiga neurogénica. Esta guía actualizada del Reino Unido ofrece recomendaciones basadas en la evidencia para el manejo de la vejiga en PwMS.
Área de la Ciencia:
- Neurología
- Urología
- Salud pública
Sus antecedentes:
- La vejiga neurogénica aumenta el riesgo de ITU en personas con esclerosis múltiple (EMP), lo que lleva a hospitalizaciones y costos de atención médica significativos.
- El último consenso del Reino Unido sobre el manejo de la vejiga de la esclerosis múltiple (EM) se publicó en 2009, por lo que es necesario actualizarlo.
- La disfunción urinaria es una complicación común y gravosa para PwMS.
Objetivo del estudio:
- Proporcionar recomendaciones actualizadas y basadas en la evidencia para la evaluación y el manejo de la disfunción del tracto urinario inferior en PwMS.
- Ofrecer orientación sobre los tratamientos de primera y segunda línea para el vaciado deteriorado y los medicamentos para los síntomas de vejiga hiperactiva.
- Promover estrategias de autogestión del paciente, incluidas las pruebas en el hogar y el seguimiento iniciado por el paciente.
Principales métodos:
- Un panel de consenso con miembros multidisciplinarios, incluidos individuos con experiencia vivida.
- Una búsqueda exhaustiva de la literatura para informar recomendaciones basadas en la evidencia.
- Desarrollo de nuevas orientaciones basadas en la discusión de expertos y la evidencia actual.
Principales resultados:
- Nuevas recomendaciones para evaluar los problemas del tracto urinario inferior en PwMS.
- Guía actualizada sobre los tratamientos farmacológicos y no farmacológicos para la disfunción de vaciado y la vejiga hiperactiva.
- Se hace hincapié en la autogestión del paciente y en la posibilidad de una vía urinaria nacional.
Conclusiones:
- La guía actualizada aborda las necesidades críticas en el manejo de la disfunción de la vejiga en PwMS.
- Una vía nacional de la vejiga para PwMS es una recomendación clave para mejorar la coordinación de la atención.
- Empoderar a los pacientes a través de la autogestión es crucial para optimizar los resultados.
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