UPPER URINARY-TRACT ABNORMALITIES IN MULTIPLE-SCLEROSIS PATIENTS WITHURINARY SYMPTOMS

Objective: To determine the prevalence of upper urinary tract complica tions in multiple sclerosis (MS) patients with urinary symptoms, and t o determine if an association exists between degree of physical impair ment and upper urinary tract complications. Design and Setting: A coho rt study of MS patients seeking treatment at a freestanding, universit y-affiliate rehabilitation hospital. Participants: A referred sample o f 48 patients with MS, exacerbation-free for 6 months with symptoms of neurogenic bladder dysfunction. For each patient, demographic data, d isease characteristics, and urologic history was obtained. Using the K urtzke Expanded Disability Status Scale (EDSS), participants were divi ded into a control (EDSS < 7) and study (EDSS greater than or equal to 7) group. Intervention: Ultrasound examination of the upper urinary t ract. Main Outcome Measure: Significant MS-related abnormalities of th e upper urinary tract. Results: Ten of 48 patients (21%) had significa nt MS-related upper urinary tract abnormalities, which were evenly dis tributed between control and study groups. In the more disabled study group, abnormalities were associated with the symptom of urinary hesit ancy (p < .05) and form of bladder management (p < .05). Conclusion: R outine screening for upper urinary tract complications appears indicat ed in a select group of MS patients with urinary symptoms. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Aca demy of Physical Medicine and Rehabilitation