Neurogenic Bladder in Multiple Sclerosis

[摘要] Background: With MS, damage to the spinal cord and brain interrupts signal transmissions that result in up to 70% of patients suffer from urinary troubles in the form of storage problems, voiding problems or a combination of both. Objective: Is to examine the  nature of the urinary problems and urodynamic changes in patients with MS and to correlate these changes with the clinical parameters of  MS as well as with the imaging and neurophysiologic changes. Subjects and Methods: Nineteen patients  with MS, suffering from urinary problems and 15 controls, were included in this study. All subjects were submitted to: complete neurological and urological examination, pelvic ultrasound, Expanded Disability Status Scale, Visual evoked potential, brain-stem evoked potential and somatosensory evoked potential, MRI brain & cervico-dorsal spine and urodynamic studies. Results: Storage problems appeared as precipitancy in 14(73.7%) patients  and incontinence in 4(21.1%) patients. Voiding problems were found in the form of hesitancy in 5(36.3%) patients and retention in one (5.3%)patient. Statistically significant difference was found between patients and controls as regards detrusor pressure at voiding phase and maximum flow rate being less in patients. Significant association was found between progressive type of MS and hesitancy  (P=0.038). Also, significant association was found between female patients & patients presenting with hesitancy and increased bladder compliance (P=0.034 & 0.03). Conclusion: urodynamic evaluation should be done and repeated at regular intervals in symptomatic MS patients to optimize clinical management, reduce complications, and better enable these patients to manage their neurogenic bladder dysfunction. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(1): 37-42]

[学科分类] 精神健康和精神病学