Lower urinary tract dysfunction in multiple sclerosis

Mayo, Michael E.; Chetner, Michael

doi:10.1016/0090-4295(92)90045-x

Cited by 70 publications

(36 citation statements)

References 9 publications

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“…5 Although 63% of patients with sacral lesions show detrusor hypocontractility, only 5% present bladder areflexia. 6 …”

Section: Pathophysiology Of Lower Urinary Tract Symptoms (Luts) In Msmentioning

confidence: 99%

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

Aharony¹,

Lam²,

Corcos³

2017

CUAJ

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Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time-and disease course-related. MS plaque location (intracranial and/or spinal) is a key feature in the pathophysiology of disease-related lower urinary tract symptoms (LUTS). The prevalence of these symptoms in MS patients is very high, with nearly 90% of them experiencing some degree of voiding dysfunction and/or incontinence. LUTS rarely present as primary MS manifestations and usually appear 6-8 years after the initial diagnosis. Symptom severity usually correlates with the disability status of patients.Patient assessment comprises clinical and advanced investigations. Each patient should be evaluated uniquely, after taking into account his/her symptoms, disease course and length, comorbidities, physical status, and medications. Basic investigation includes detailed history-taking, physical examination, and post-void residual volume measurement. Advanced evaluation consists of imaging and specific testing, with pivotal importance on urodynamic study.

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“…5 Although 63% of patients with sacral lesions show detrusor hypocontractility, only 5% present bladder areflexia. 6 …”

Section: Pathophysiology Of Lower Urinary Tract Symptoms (Luts) In Msmentioning

confidence: 99%

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

Aharony¹,

Lam²,

Corcos³

2017

CUAJ

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“…Apparaissant en moyenne 6 ans après le début de la maladie (5 à 9,5 ans) [2, 9,13,14,16,21,23], ces troubles peuvent affecter un patient sur dix dès la première poussée [24][25][26][27][28]. Ce caractère inaugural a été corrélé avec la sévérité du tableau clinique et urodynamique vésico-sphinctérien ultérieur, et il pourrait majorer la morbidité vésico-sphinctérienne [29] (NP1).…”

Section: Analyse De La Littératureunclassified

“…Sur le plan démographique, l'âge n'exerce pas d'influence directe, mais le genre pourrait, comme dans la population générale, prédisposer les femmes à l'incontinence urinaire et aux symptômes irritatifs, et les hommes aux symptômes obstructifs [3,6,10,15,20,23,27,28]. [16,30,46].…”

Section: Analyse De La Littératureunclassified

Neurogenic bladder in Multiple Sclerosis: Review and proposal of management guidelines

Sèze

Ruffion²,

Denys

et al. 2006

Pelv Perineol

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Les troubles vésico-sphinctériens sont extrê-mement fréquents dans la SEP, et ils sont responsables d'un retentissement fonctionnel lié aux conséquences des désordres mictionnels sur la qualité de vie quotidienne et organique, secondaire aux complications des neurovessies sur l'appareil urinaire. Si l'impact fonctionnel et ses modes de prise en charge sont bien documentés dans la littérature, l'impact organique reste sous-évalué, et il n'existe pas de guide consensuel de prise en charge pratique visant à dépister et à prévenir les complications uro-néphrologiques des neurovessies de la SEP.La première partie de notre travail avait pour objectif d'identifier, par une analyse exhaustive de la littérature, les facteurs influençant le pronostic des complications uronéphrologiques dans la SEP. La seconde partie, réalisée conjointement avec le GENULF (Groupe d'étude neurourologique de langue française) et rapportée ultérieurement, proposera des recommandations éclairées pour la surveillance à moyen et long terme des neurovessies dans la SEP conformément à la méthodologie préconisée par l'ANAES.Abstract: Micturitional disorders are very frequent in multiple sclerosis, leading to functional repercussion on daily life activity and to morphologic damage on upper urinary tract. The functional impact of bladder disorders and its management is widely documented but the organic consequence remained underestimated and there is none consensual proposal for practical follow-up. Our purpose was to perform a detailed review on the literature concerning the neurogenic bladder in multiple sclerosis, analysing the risk factor for upper tract deterioration, in order to be helpfull for the proposal of a documented guidelines for comprehensive management in the middle and long term.

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“…1 A combination of detrusor hyperre¯exia and incomplete emptying is the most common bladder problem, incomplete emptying occurring as a result of poor detrusor contractions and detrusor sphincter dyssynergia. 2 Treatment of bladder dysfunction using intermittent self catheterisation is determined by the post micturition residual urine volume. 3 As a general rule, intermittent catheterisation is recommended if the residual urine volume is in excess of 100 ml.…”

Section: Introductionmentioning

confidence: 99%

The value of the Kurtzke Functional Systems Scales in predicting incomplete bladder emptying

Kirchhof

Fowler

2000

Spinal Cord

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Study design: A ®eld study was conducted in 40 patients with multiple sclerosis (MS) by comparing their residual urine volumes with the Kurtzke Functional Systems Scales for pyramidal (PFS) or bladder functions (BFS). Objectives: To determine whether raised residual urine volumes necessitating intermittent self catheterisation can be predicted by the PFS or BFS. Setting: Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals Trust, London, UK. Methods: In 40 patients with MS, post micturition residual volumes were measured with ultrasound prior to any treatment of bladder dysfunction. The patients' symptoms were assessed using PFS and BFS. Correlation between PFS, BFS and post micturition residual volumes were calculated as were sensitivity and speci®city of PFS and BFS in predicting incomplete bladder emptying with residuals above 100 ml. Results: None of the patients with a PFS or BFS of 0 or 1 had a residual of more than 100 ml. There was a linear progression of maximal residuals with PFS and BFS. Correlation between PFS (BFS) and the post micturition residual volumes was 0.37 (0.71). Conclusion: Unless a patient with MS has a PFS or BFS of greater than 1 they are unlikely to have incomplete bladder emptying with post micturition residual volumes above 100 ml. With PFS of BFS greater than 1 measurement of the post voiding residual volume is mandatory. Spinal Cord (2000) 38, 409 ± 413

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Lower urinary tract dysfunction in multiple sclerosis

Cited by 70 publications

References 9 publications

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

Evaluation of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

Neurogenic bladder in Multiple Sclerosis: Review and proposal of management guidelines

The value of the Kurtzke Functional Systems Scales in predicting incomplete bladder emptying

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