Clinical management of the neurourological syndrome associated with multiple sclerosis and correlations to grade of the disease

Abstract

Purpose: In this study a detailed clinical management is presented as it is practiced in our department, and possible correlations between grade of the disease and therapeutic responses are examined. Materials and methods: One hundred and ten patients were consecutively and prospectively studied with a clinical syndrome of MS, ranging in age from32 to 65 years of age. Clinical diagnosis of the voiding dysfunction associated with MS was classified as a malfunction causing either problems of bladder evacuation, or storage, or a combination of both. Therapeutic responses of the voiding dysfunction were correlated with grade of the disease. Mean follow up period was 54 months. Results: All patients were initially managed in a conservative way avoiding surgical procedures and following primarily pharmacologic treatment, because of the quite common reversibility of MS. A possible correlation of response to treatment according to grade of the disease was studied. There was significant difference in the response to drug treatment among patients of different grades favoring grade 1 patients with both storage and evacuation voiding dysfunction. Conclusions: Our suggested treatment has secured the conversion of a high pressure into a low pressure vesicourethral system,thus obviating possible risk factors for the upper urinary tract and the bladder itself. Therapeutic responses were dependent upon the grade of the disease.