URINARY-TRACT DYSFUNCTION IN MULTIPLE-SCLEROSIS - IS THERE A RELATIONWITH DISEASE-RELATED PARAMETERS

The lower urinary tract is affected by multiple sclerosis in many pati ents. We screened urologically and neurologically 120 patients with a confirmed diagnosis of multiple sclerosis. The mean age was 42 years ( range 22 to 69 years). Urodynamic investigation as well as neuro-uroph ysiological investigations were performed in all patients. Renal ultra sound was used to study morphology, and excretory urogram (IVU) was us ed to assess renal function and the upper urinary tracts in 105 patien ts. Obstructive symptoms were found more commonly than irritative symp toms. The urinary symptoms were found to be related to disease duratio n and not to disability status. Urodynamic abnormalities were statisti cally significantly related to disease duration (X(2) = 38.51; P = 0.0 001), and to the disability status (X(2) = 76.70; P = 0.0001). Few pat ients, only 3.3%, had upper urinary tract dilatation. With medical man agement, hydronephrosis disappeared in all of the patients and did not recur. A combination of oral pharmacological agents and clean intermi ttent catheterization was used in the majority of the patients. We con clude that lower urodynamic abnormalities can be present in every pati ent with multiple sclerosis, and appear to be related to disease durat ion and disability status, thus early treatment based upon urodynamic evaluation and close follow-up can reduce morbidity and improve the qu ality of life.