Lower urinary tract dysfunction and disability status in patients with multiple sclerosis

Objective: To investigate the correlation between neurologic and urologic s tatus in patients with multiple sclerosis (MS). Materials and Methods: Between January 1993 and December 1995, 116 patients with MS symptoms were fully assessed neurologically and urologically with urodynamic studies. Results: Urodynamic abnormalities were detected in 104 patients (89.6%). Se veral significant relationships between urinary tract findings and neurolog ic dysfunction were: (1) the relation between voiding disorder as the prese nting symptom of the disease and a higher severity of bladder dysfunction; (2) the relation between reduced bladder sensation and longer duration of v oiding disorders, lower detrusor uninhibited contractions threshold, and lo wer bladder capacity; and (3) the relation between voiding disorders and ce rebellar system score. Finally, a significant inverse relationship was foun d between detrusor hypocontractility and neurologic status (from the Expand ed Disability Status Scale, pyramidal system score, and Barthel Index). Conclusions: In this series a high incidence of patients reported voiding d isorder as the presenting symptom of MS. These patients also showed a highe r severity of urodynamic disorders. They should be rigorously followed up. Furthermore, our data suggest that although the most common cause of altere d bladder control in MS is spinal cord pathology, involvement of cortical c enters and/or peripheral neuronal lesions may occur. (C) 1999 by the American Congress of Rehabilitation Medicine and the Americ an Academy of Physical Medicine and Rehabilitation.