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Lower Urinary Tract Dysfunction And
Disability Status In Multiple Sclerosis


Giannantoni A, Scivoletto G, Di Stasi SM, Grasso MG, Finazzi Agro E, Collura G, Vespasiani G
Arch Phys Med Rehabil 1999 Apr;80(4):437-41
S. Lucia IRCCS Rehabilitation Hospital, Rome, Italy
PMID# 10206607; UI# 99221448
Abstract

Objective
To investigate the correlation between Neurologic and Urologic Status in patients with Multiple Sclerosis (MS).

Methods & 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%). Several significant relationships between Urinary Tract findings and Neurologic Dysfunction were:

  1. Relation between Voiding Disorder as the presenting symptom of the disease and a higher severity of Badder Dysfunction;

  2. Relation between reduced Badder Sensation and longer duration of Voiding Disorders, lower Detrusor uninhibited contractions threshold, and lower Badder Capacity;

  3. Relation between Voiding Disorders and Cerebellar System score;

  4. A significant inverse relationship was found between Detrusor HypoContractility and Neurologic Status (from the Expanded Disability Status Scale, Pyramidal System score, and Barthel Index).

Conclusions
In this series a high incidence of patients reported Voiding Disorder as the presenting symptom of MS. These patients also showed a higher severity of Urodynamic Disorders. They should be rigorously followed up.

Furthermore, our data suggest that although the most common cause of altered Badder control in MS is Spinal Cord pathology, involvement of Cortical centers and/or Peripheral Neuronal lesions may occur.



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