Evidence for Early Lower Urinary Tract Dysfunction in Clinically Silent Multiple Sclerosis

Abstract

The occurrence of micturition complaints as late sequelae of multiple sclerosis is well studied and documented. However, no reports exist on urologically asymptomatic patients with a relatively short disease duration. In a prospective study of 40 patients with definite multiple sclerosis (mean disease duration 5 years), urodynamic investigations (cystometry and pressure-flow study) were combined with neuro-urophysiological measurements (cortical evoked potentials and sacral reflex latencies). Patients with (13) and without (27) micturition complaints were investigated. Neurourodynamic abnormalities were seen in 35 of 40 patients (88%). The lower urinary tract proved to be afflicted by multiple sclerosis at an early stage of the disease. Early neurourodynamic investigations had clinical implications. All of the complaining and half of the noncomplaining patients showed urodynamic abnormalities upon which the need for further followup and eventual therapeutic intervention was based. We conclude that neurourodynamic testing of a urinary functional system can be worthwhile as part of the initial diagnostic evaluation in patients with proved multiple sclerosis.

Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters?

“…Half of the patients who did not have urinary complaints on questioning had objective urodynamic abnormalities. 5 This con®rms once more that lower urinary tract symptoms do not correlate with the underlying pathophysiology of bladder dysfunction, and suggests that urodynamic evaluation is necessary. Some authors 15 suggest that the urological evaluation of this disease should be limited to physical examination and post-void residual urine measurement; we agree with other investigators 10,16 that urodynamic evaluation of bladder function is critical to establish a treatment program.…”

“…3,4 Some studies report that objective lower urinary tract dysfunction can be present without complaints. 5 Several investigators found a poor relationship between the subjective complaints and the objective neurological parameters. Therefore, a neurourological diagnostic evaluation seems to be mandatory both in patients with urological complaints and in those without symptoms.…”

Urodynamic Study of Bladder Function for Patients with Lumbar Spinal Stenosis Treated by Surgical Decompression

“…Bemelmans et al 4 also described the presence of altered urodynamic patterns in 52% of patients without clinical symptoms. This indicates that urodynamic evaluation might play an important role in the early diagnosis of neurogenic bladder dysfunction.…”

Factores pronósticos del tratamiento endoscópico del reflujo vesicoureteral en pacientes con lesión medular

“…La esclerosis múltiple causa DNTUI en el 50 % al 90 % de los pacientes 102 . La incidencia comunicada de disfunción miccional en la esclerosis múltiple es del 33 % al 52 % en pacientes seleccionados de forma consecutiva, con independencia de los síntomas urinarios.…”

“…La incidencia comunicada de disfunción miccional en la esclerosis múltiple es del 33 % al 52 % en pacientes seleccionados de forma consecutiva, con independencia de los síntomas urinarios. Esta incidencia está relacionada con el grado de discapacidad del paciente 102 .Hay casi un 100 % de posibilidades de presentar disfunción del TUI cuando estos pacientes experimentan problemas para caminar. La DNTUI es el síntoma inicial en el 2 % al 12 % de los pacientes y este hallazgo llega a ser del 34 % en algunos estudios 102.…”