Clinical Characteristics and Urodynamic Analysis of Urinary Dysfunction in Multiple Sclerosis
- Author:
- No author available
- Journal Title:
- Chinese Medical Journal
- Issue:
- 6
- DOI:
- 10.4103/0366-6999.177970
- Key Word:
- Lower Urinary Tract Dysfunction;Multiple Sclerosis;Urinary Symptoms;Urodynamic
Abstract： Background:Both lower urinary tract dysfunction and urinary symptoms are prevalent in patients with multiple sclerosis (MS).Although the significance of identifying and treating urinary symptoms in MS is currently well-known,there is no information about the real prevalence and therapeutic effect of urinary symptoms in patients with MS.The purpose of this study was to analyze the major symptoms and urodynamic abnormalities,and observe the therapeutic effect in different MS characteristics.Methods:We enrolled 126 patients with urological dysfunction who were recruited between July 2008 and January 2015 in Beijing Tian Tan Hospital,Capital Medical University and conducted overactive bladder system score (OABSS),urodynamic investigation,and expanded disability status scale (EDSS).Changes of urinary symptoms and urodynamic parameters were investigated.Results:Urgency was the predominant urinary symptom,and detrusor overactivity was the major bladder dysfunction.There was a positive correlation between EDSS and OABSS.Clinically isolated syndrome (CIS) had lowest EDSS and OABSS.CIS exhibited significant improvements in OABSS,maximum urinary flow rate (Qmax),and bladder volume at the first desire to voiding and maximum bladder volume after the treatment (P ＜ 0.05).Relapsing-remitting MS showed significant improvements in the OABSS,Qmax,and bladder volume at the first desire to voiding,maximum bladder volume and bladder compliance after the treatment (P ＜ 0.05).Progressive MS exhibited significant increase in the bladder volume at the first desire to voiding,the detrusor pressure at maximum flow rate (PdetQmax),and bladder compliance after the treatment (P ＜ 0.05).Conclusions:Urodynamic parameters examined are important in providing an accurate diagnosis,guiding management decisions of MS.Early and effective treatment may improve the bladder function and the quality of life at the early stages of MS.
- [1]Bove, Riley,Chitnis, Tanuja.The role of gender and sex hormones in determining the onset and outcome of multiple sclerosis[J].2014,20(5).
- [2]D, Caramella,G, Donatelli,N, Armillotta,etc.Videourodynamics in patients with neurogenic bladder due to multiple sclerosis: our experience.[J].2011,116(3).
- [3]H P, Hartung,J J, Archelos,J, Zielasek,etc.Circulating adhesion molecules and inflammatory mediators in demyelination: a review.[J].1995,45.
- [4]Frohman EM,Zimmern PE,Ramnarayan P,etc.Urodynamic distinctions between idiopathic detrusor overactivity and detrusor overactivity secondary to multiple sclerosis.[J].2006,67(5).
- [5]Pushkar, Shah.Symptomatic management in multiple sclerosis.[J].2015,18.
- [6]Wiedemann,A.,Kaeder,M.,Greulich,W.,etc.Which clinical risk factors determine a pathological urodynamic evaluation in patients with multiple sclerosis? an analysis of 100 prospective cases[J].2013,31(1).
- [7]?etinel,B.,Tarcan,T.,Demirkesen,O.,etc.Management of lower urinary tract dysfunction in multiple sclerosis: A systematic review and Turkish consensus report[J].2013,32(8).
- [8]Montalban X,Polman CH,Filippi M,etc.Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.[J].2011,69(2).
- [9]Bulent, Onal,Aksel, Siva,Ibrahim, Buldu,etc.Voiding dysfunction due to multiple sclerosis: a large scale retrospective analysis.[J].1900,35.
- [10]Ozawa K,Araki I,Kuno S,etc.Relationship of bladder dysfunction to lesion site in multiple sclerosis.[J].2003,169(4).
- [11]Paul Abrams,Linda Cardozo,Magnus Fall,etc.The standardisation of terminology of lower urinary tract function: Report from the standardisation sub-committee of the International Continence Society[J].2002,21(2).
- [12]Kelly, Hilven,An, Goris.Genetic burden mirrors epidemiology of multiple sclerosis.[J].2015,21.
- [13]Compston A,Coles A.Multiple sclerosis.[J].2008,372(9648).
- [14]Passakos C,Barbalias D,Liatsikos EN,etc.Vesicourethral dysfunction associated with multiple sclerosis: correlations among response, most prevailing clinical status and grade of the disease.[J].2001,32(3).
- [15]Tadayyon, Farhad,Etemadifar, Masoud,Bzeih, Hussein,etc.Association of urodynamic findings in new onset multiple sclerosis with subsequent occurrence of urinary symptoms and acute episode of disease in females[J].2012,17(4).
- [16]Sterling AM,Abrams P,Mattiasson A,etc.Good urodynamic practices: Uroflowmetry, filling cystometry, and pressure-flow studies.[J].2002,21(3).
- [17]Del-Corso F,Panariello G,Del-Popolo G,etc.Diagnosis and therapy for neurogenic bladder dysfunctions in multiple sclerosis patients.[J].2008,29(Suppl.4).
- [18]Lemack GE,Hawker K,Frohman E.Incidence of upper tract abnormalities in patients with neurovesical dysfunction secondary to multiple sclerosis: analysis of risk factors at initial urologic evaluation.[J].2005,65(5).
- [19]Declan T Chard,David H Miller,Olga Ciccarelli.Clinically isolated syndromes.[J].2012,11(2).
- [20]DasGupta R,Fowler CJ.Sexual and urological dysfunction in multiple sclerosis: better understanding and improved therapies.[J].2002,15(3).
- [21]Mutchnik SE,Ciancio SJ,Rivera VM,etc.Urodynamic pattern changes in multiple sclerosis.[J].2001,57(2).
- [22]Kurtzke JF.Historical and clinical perspectives of the Expanded Disability Status Scale.[J].2008,31(1).
- [23]Daniel S, Engeler,Daniel, Meyer,Dominik, Abt,etc.Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: a single-centre prospective series.[J].2015,15.