Bladder dysfunction (BD) is the most common autonomic disturbance in multiple sclerosis, but often overlooked and undertreated. The purpose of this longitudinal study was to explore the changes in the frequency of BD symptoms in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the correlations between the presence of BD symptoms and both clinical characteristics and the health-related quality of life (HRQoL) at each subsequent point of estimation. The study population comprises a cohort of 93 patients with MS (McDonald’s criteria, 2001). At each time point (baseline, and at the 3- and 6-year follow-up) of estimation, Expanded Disability Status Scale, Hamilton Rating Scale for Depression, Fatigue Severity Scale, Szasz Sexual Functioning Scale and HRQoL (measured by MSQoL-54) were assessed. The proportion of patients with at least one symptom of BD significantly increased over time, for both men and women (from 48.1% at baseline to 51.9% after 3 years and to 71.4% after 6 years of follow-up for males and from 45.5% at baseline to 50.0% after 3 years and to 66.7% after 6 years of follow-up for females). The most common BD problem was urgency of urination. The presence of BD was statistically significantly associated with higher level of physical disability, sexual dysfunction and HRQoL at each point of follow-up, for both men and women. Our results suggested outstanding frequency of BD in patients with MS, with increasing tendency over time.
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Phe V, Chartier-Kastler E, Panicker JN (2016) Management of neurogenic bladder in patients with multiple sclerosis. Nat Rev Urol 13(5):275–288
Nakipoglu GF, Kaya AZ, Orhan G, Tezen O, Tunc H, Ozgirgin N, Ak F (2009) Urinary dysfunction in multiple sclerosis. J Clin Neurosci 16(10):1321–1324
Panicker JN, Fowler CJ (2015) Lower urinary tract dysfunction in patients with multiple sclerosis. Handb Clin Neurol 130:371–381
Browne C, Salmon N, Kehoe M (2015) Bladder dysfunction and quality of life for people with multiple sclerosis. Disabil Rehabil 37(25):2350–2358
McCombe PA, Gordon TP, Jackson MW (2009) Bladder dysfunction in multiple sclerosis. Expert Rev Neurother 9(3):331–340
DasGupta R, Fowler CJ (2003) Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs 63(2):153–166
Kalsi V, Fowler CJ (2005) Therapy insight: bladder dysfunction associated with multiple sclerosis. Nat Clin Pract Urol 2(10):492–501
Fragalà E, Russo GI, Di Rosa A, Giardina R, Privitera S, Favilla V, Castelli T, Chisari M, Caramma A, Patti F, Cimino S, Morgia G (2015) Relationship between urodynamic findings and sexual function in multiple sclerosis patients with lower urinary tract dysfunction. Eur J Neurol 22(3):485–492
Ciancio SJ, Mutchnik SE, Rivera VM, Boone TB (2001) Urodynamic pattern changes in multiple sclerosis. Urology 57(2):239–245
Tepavcevic DK, Kostic J, Basuroski ID, Stojsavljevic N, Pekmezovic T, Drulovic J (2008) The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis. Mult Scler 14(8):1131–1136
McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS (2001) Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 50(1):121–127
Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33(11):1444–1452
Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123
Szasz G, Paty D, Maurice WL (1984) Sexual dysfunctions in multiple sclerosis. Ann NY Acad Sci 436:443–452
Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296
Vickrey BG, Hays RD, Harooni R, Myers LW, Ellison GW (1995) A health-related quality of life measure for multiple sclerosis. Qual Life Res 4:187–206
SF-36 Health Survey (Original version). Language Recalls. http://www.qualitymetric.com
Pekmezovic T, Kisic Tepavcevic D, Kostic J, Drulovic J (2007) Validation and cross-cultural adaptation of the disease-specific questionnaire MSQoL-54 in Serbian multiple sclerosis patients sample. Qual Life Res 16:1383–1387
Likert RA (1931) A technique for the development of attitudes. Arch Psychol 140:5–55
Tepavcevic DK, Pekmezovic T, Stojsavljevic N, Kostic J, Basuroski ID, Mesaros S, Drulovic J (2014) Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study. Qual Life Res 23(3):1027–1037
Kisic-Tepavcevic D, Pekmezovic T, Trajkovic G, Stojsavljevic N, Dujmovic I, Mesaros S, Drulovic J (2015) Sexual dysfunction in multiple sclerosis: a 6-year follow-up study. J Neurol Sci 358(1–2):317–323
de Sèze M, Ruffion A, Denys P, Joseph PA, Perrouin-Verbe B (2007) The neurogenic bladder in multiple sclerosis: review of the literature and proposal of management guidelines. Mult Scler 13(7):915–928
Betts CD, D’Mellow MT, Fowler CJ (1993) Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 56(3):245–250
Haab F (2014) The conditions of neurogenic detrusor overactivity and overactive bladder. Neurourol Urodyn 33(Suppl 3):S2–5
de Almeida CR, Carneiro K, Fiorelli R, Orsini M, Alvarenga RM (2013) Urinary dysfunction in women with multiple sclerosis: analysis of 61 patients from rio de janeiro. Brazil. Neurol Int 5(4):e23
Nortvedt MW, Riise T, Myhr KM, Landtblom AM, Bakke A, Nyland HI (2001) Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction. Mult Scler 7(4):231–235
Nortvedt MW, Riise T, Frugård J, Mohn J, Bakke A, Skår AB, Nyland H, Glad SB, Myhr KM (2007) Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult Scler 13(1):106–112
Betts CD, Jones SJ, Fowler CG, Fowler CJ (1994) Erectile dysfunction in multiple sclerosis. Associated neurological and neurophysiological deficits, and treatment of the condition. Brain 117(6):1303–1310
Fragalà E, Privitera S, Giardina R, Di Rosa A, Russo GI, Favilla V, Caramma A, Patti F, Cimino S, Morgia G (2014) Determinants of sexual impairment in multiple sclerosis in male and female patients with lower urinary tract dysfunction: results from an Italian cross-sectional study. J Sex Med 11(10):2406–2413
Vitkova M, Rosenberger J, Krokavcova M, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP (2014) Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction. Disabil Rehabil 36(12):987–992
Patel DP, Elliott SP, Stoffel JT, Brant WO, Hotaling JM, Myers JB (2016) Patient reported outcomes measures in neurogenic bladder and bowel: a systematic review of the current literature. Neurourol Urodyn 35(1):8–14
This work was supported by the Ministry of Education and Science of the Republic of Serbia (Grant Nos. 175087 and 175031).
Conflict of interest
Authors declare no potential conflict of interest with respect to the research, authorship and/or publication of this article.
The study was approved by the Hospital Ethics Committee.
Prior to study entry, they provided their informed consent.
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Kisic Tepavcevic, D., Pekmezovic, T., Dujmovic Basuroski, I. et al. Bladder dysfunction in multiple sclerosis: a 6-year follow-up study. Acta Neurol Belg 117, 83–90 (2017). https://doi.org/10.1007/s13760-016-0741-z