FATE OF THE UPPER URINARY-TRACT IN MULTIPLE-SCLEROSIS

Urologic problems are a major source of morbidity for patients with mu ltiple sclerosis (MS). Fifty-four to 78% of patients experience bladde r symptoms which are due to spinal lesions interrupting neural pathway s that control micturition. MS patients could have upper or lower moto r neuron lesion type bladders. Both obstructive and irritative symptom s may be present. Although lower urinary tract dysfunction has been we ll described in MS, few studies have investigated the fate of the uppe r urinary tract. Thirty-two patients with MS were referred for urodyna mic evaluation. Twenty-six of the 32 patients had upper urinary tract studies performed. Only 1 of the 26 patients had evidence of upper uri nary tract deterioration. It is our impression that upper tract deteri oration occurs infrequently in these patients. We discuss clinical clu es that may predict deterioration. (C) 1995 Wiley-Liss, Inc.