BLADDER DYSFUNCTION AND MANAGEMENT IN MULTIPLE-SCLEROSIS

Symptomatic bladder dysfunction occurs at some time in most patients w ith multiple sclerosis, The relapsing-remitting course and progressive loss of mobility associated with multiple sclerosis make management o f urinary urgency and incontinence difficult, Urodynamic evaluation se rves as a guideline for appropriate treatment, After accurate diagnosi s of bladder dysfunction, a management program is developed with use o f fluid schedules, voiding techniques, neuropharmacologic manipulation , intermittent catheterization, surgical treatment, and other adjuncti ve measures as indicated, The goals of treatment are to protect and pr eserve renal function, relieve symptomatic voiding dysfunction, and av oid subsequent urinary complications, A management program should be i ndividualized, dynamic, and monitored with periodic, systematic urolog ic review to maintain these goals.