Urodynamic pattern chances in multiple sclerosis

Objectives. Multiple sclerosis (MS) causes neurologic symptoms to change ov er time. Voiding dysfunction is common in patients with MS, and few studies have examined the changes in urodynamic patterns in these patients over ti me. The purpose of this study was to examine the frequency and nature of ur odynamic pattern changes in patients with MS who underwent two or more urod ynamic studies. Methods. Twenty-two patients (7 men and 15 women) with well-documented MS w ere referred to one urologist (T.B.B.) for evaluation of lower urinary trac t symptoms. All patients had undergone two or more urodynamic evaluations d uring a 14-year period for persistent or new symptoms, and a retrospective comparison was made among the urodynamic test results. Results. Overall, 12 (55%) of 22 patients experienced a change in their uro dynamic patterns and/or compliance during a mean follow-up interval of 42 /- 45 months between the urodynamic studies. Most patients initially had ur odynamic patterns showing detrusor hyperreflexia, detrusor external sphinct er dyssynergia, or detrusor hypocontractility. Fourteen (64%) of the 22 pat ients studied had the same or worsening of the same symptoms and 8 (36%) of 22 had new urologic symptoms. Six (43%) of 14 patients with no new symptom s and 6 (75%) of 8 with new symptoms had significant changes found with fol low-up urodynamic testing. Conclusions. A significant proportion of patients with MS with and without new urinary symptoms will develop changes in their underlying urodynamic pa tterns and detrusor compliance. Therefore, urodynamic evaluations should be repeated at regular intervals in symptomatic patients to optimize clinical management, reduce complications, and better enable these patients to mana ge their neurogenic bladder dysfunction. UROLOGY 57: 239-245, 2001. (C) 200 1, Elsevier Science Inc.