Urinary tract infections in multiple sclerosis

Abstract

Background: Urinary tract infections (UTIs) are commonly reported by people with multiple

Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis

“…Randomized controlled trials suggested a benefit of using D‐mannose in non‐neurological women experiencing recurrent UTIs . However, no clinical trials have been undertaken to test feasibility of using D‐mannose among neurological patients . D‐mannose is safe product, classed as a food supplement, with no significant safety signals identified in open label studies, with only diarrhoea rarely reported .…”

“…In patients using catheters, the value of the dipstick tests is less clear, because of the high prevalence of abnormal findings and asymptomatic bacteriuria . In this group in particular, symptoms and signs would guide the decision‐making process …”

“…Participants were instructed to self‐monitor suspected UTIs. At the initial study visit they were educated about the symptoms and signs of UTIs including the presence of cloudy malodorous urine, haematuria, fever, feeling unwell, painful micturition, recent worsening of urgency/frequency/incontinence, suprapubic/flank pain, loin, or abdominal discomfort, leakage between intermittent self‐catheterization, catheter blockage, reduced appetite, and otherwise unexplained deterioration of pre‐existing neurological condition or mobility and/or increasing spasticity . They were taught to use combined rapid urinalysis reagent strips (urine dipsticks) (Nature supplies, D‐Mannose Ltd.) and read the results for leukocyte esterase and nitrites.…”

“…Urinary tract infections (UTIs) commonly occur in patients with multiple sclerosis (MS) reporting lower urinary tract (LUT) dysfunction and are reported in 30% (ranging from 13% to 80%) of patients . Factors that predispose to UTIs have been poorly investigated in patients with MS, though postulated risk factors are incomplete bladder emptying, the use of a catheter, either intermittently or indwelling, and female gender .…”

Disease-Specific Outcomes of Botulinum Toxin Injections for Neurogenic Detrusor Overactivity

“…35 Initiating CIC is a burden in general, and it is even more so to patients in whom lower extremity spasms, compromised hand dexterity, or visual disturbances may be present. The cost and side effects (hematuria, pain, trauma, strictures, and UTI) associated with CIC also need to be considered.. 36 Clinicians should also be aware that UTIs worsen urinary symptoms in MS patients and significantly impact their QOL 37 and may trigger pathways that result in exacerbation of MS and its neurological progression. 38,39 Furthermore, in the longest follow-up study of the use of onabotulinumtoxinA (15 years), the overall discontinuation rate amongst all neurogenic patients (SCI, MS, MMC) was 40%, and only 14% of MS patients continued with the treatment.…”