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

Abstract

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

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

“…Few and heterogeneous studies have investigated the relationship between subjective urinary complaints and objective urological parameters in MS patients, reaching different conclusions [3,[5][6][7][8][9]. Is a routinary evaluation of urinary symptoms sufficient to exclude the presence of bladder dysfunction in patients with MS?…”

Evaluation and management of neurogenic vesicourethral dysfunction in multiple sclerosis

“…A relationship between MS duration and adverse urodynamic fi ndings (detrusor overactivity, detrusor hypocontractility, DSD) has been demonstrated [6][7][8]19]. Irritative symptoms and neurovesical dysfunction have been correlated with EDSS scores [6,17,[19][20][21], individual Kurtzke Functional System Scales scores [19,22], Babinski sign [8], and lower limb spasticity [17,22]. Therefore, any history of ataxia, gait disturbance, unexplained lower extremity weakness, numbness, or paresthesias suggests concomitant urologic symptoms and may signal occult VUD.…”

“…Two studies have specifi cally focused on the offi ce-based PVR measurement in MS patients [18,22]. Kragt et al [18] studied 297 patients with MS and found that 17% with pyramidal function scale scores of 1 or lower had clinically relevant PVRs.…”

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

“…La prévalence des TVS cliniques apparaît corrélée avec la sévérité des déficiences globales (score EDSS, échelle de Kurtzke) [5,6,9,20,32,33], et celle des symptômes irritatifs est également corrélée avec la sévérité de l'atteinte pyramidale (signe de Babinski, score pyramidal de l'EDSS) [5,9,20]. La corrélation entre la rétention urinaire et le statut neurologique reste débattue [34,35].…”