Urodynamic changes in patients with multiple sclerosis with lower urinary tract symptoms

Abstract

Background and Objective: Urinary tract disorders are widely prevalent among patients with multiple sclerosis. Early and correct diagnosis of symptom patterns and early and targeted therapeutic strategy through urodynamic study for patients with symptomatic multiple sclerosis are essential to improve the patient's quality of life and avoid future complications. We aim to study urinary disorders associated with multiple sclerosis and verify the relationship between clinical and demographic characteristics of patients, and collect the findings of dynamic studies of these patients

Materials and Methods: A cross-sectional study of patients with multiple sclerosis who visited the urology clinic with lower urinary symptoms at National University Hospital in Damascus, during the period from 1/2023 to 1/2024. Demographic variables (age and sex) and clinical variables were taken, then patients were prepared for a urodynamic study and the observed results were recorded.

Results: The study included 16 patients with symptomatic MS, with a mean age of 36.4 ± 11.1 years, 9 (56.25%) were male, and the mean duration of MS was 8 ± 5.9 years. Urge incontinence was the most common finding (56.25%), urinary urgency and frequency were seen in 4 patients (25%). 8 patients (50%) had voiding difficulties and urinary retention was seen in 2 patients (12.5%). Urodynamic study suggested an overactive bladder with possible detrusor-sphincter dyssynergia in 7 patients (43.75%), neurogenic spastic bladder in 6 patients (37.5%), and neurogenic flaccid bladder in 3 patients (18.75%)..

Conclusion: Urodynamic study is the most effective method to determine the type of urinary dysfunction in MS patients.  Note that overactive bladder and detrusor-sphincter dyssynergia are the most common urodynamic changes in patients with MS.

Keywords: Overactive bladder, Multiple Sclerosis, Urodynamic study