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- Title
Which clinical risk factors determine a pathological urodynamic evaluation in patients with multiple sclerosis? an analysis of 100 prospective cases.
- Authors
Wiedemann, A.; Kaeder, M.; Greulich, W.; Lax, H.; Priebel, J.; Kirschner-Hermanns, R.; Füsgen, I.
- Abstract
Background: Urinary tract symptoms are an underestimated problem in multiple sclerosis (MS). Objective: Hundred urodynamics of MS patients have been evaluated prospectively. Design, setting and participants: In an inpatient rehabilitation, all persons with MS who also suffered from urinary tract symptoms received a voiding diary, post-void sonography and an urodynamic examination according to International Continence-Society-Standard. Results and limitations: Between 10/2009 and 3/2011, 100 patients (79 women; 21 men; mean EDSS, 4.52 ± 2.26) were examined who had primary progressive MS (9×), relapsing-remitting MS (41×), secondary progressive MS (43×) and CIS (1×). The mean duration of MS was 10.26 ± 10.09 years and mean duration of LUTS, 6.9 ± 7.75 years. Urodynamic testing showed normal findings in 22 patients, detrusor overactivity in 7, increased bladder sensation without detrusor overactivity in 21, detrusor-sphincter dyssynergia in 26, detrusor hypocontractility in 12, detrusor acontractility in 4 and unclear diagnosis in 8 patients. Statistically significant risk factors for pathological urodynamic findings were as follows: wheelchair dependency, use of more than one incontinence pad per day and a MS type other than relapsing-remitting. Conclusions: The urodynamic investigation at hand showed urinary tract dysfunction in 78 of 100 MS patients with lower urinary tract symptoms (LUTS). The long latency between the occurrence of MS and/or the beginning of LUTS and the first neuro-urological evaluation indicates a deficit in treatment. Beyond national guidelines, all MS patients should at regular intervals be questioned about LUTS and receive urodynamic assessment especially according to the presented risk profile.
- Subjects
URODYNAMICS; URINARY organ disease diagnosis; MULTIPLE sclerosis; MEDICAL rehabilitation; MEDICAL statistics; CLINICAL trials; PATIENTS
- Publication
World Journal of Urology, 2013, Vol 31, Issue 1, p229
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-011-0820-y