Make your own free website on Tripod.com

Multiple Sclerosis & The Urologist

Litwiller SE, Frohman EM, Zimmern PE
J Urol 1999 Mar;161(3):743-57
Dept ofUrology, Univ of Texas Southwestern Medical Center, Dallas, USA
UI# 99145276
Abstract

Purpose
We provide an updated reference detailing the Neurological and Urological state of the art approach to Multiple Sclerosis (MS) with special emphasis on the pathology and physiology, effects on the GenitoUrinary Tract, diagnostic evaluation, and treatment of Neurological and Urological manifestations.

Materials & Methods
A MEDLINE computerized reference search and manual bibliography review were performed to find pertinent peer reviewed articles on the Neurological and Urological manifestations and treatment of MS.

A meta-analysis was performed on the Urodynamic findings of 22 studies involving 1,882 patients from well-defined MS populations.

Results
The majority of patients with MS have GenitoUrinary symptoms ranging from Urgency, Urge Incontinence and Frequency to Urinary Retention. Symptoms do not accurately reflect the underlying Urological pathology but parallel Pyramidal Tract Dysfunction.

Urodynamic Evaluation has an important role in determining proper Bladder Management.

The most common Urodynamic finding is Detrusor HyperReflexia in 62% of these patients, followed by Detrusor-Sphincter DysSynergia in 25% and Hypocontractility in 20%. Less than 1% of patients have renal deterioration and most may be treated with conservative measures.

If conservative measures fail, new forms of Bladder reconstruction and diversion may be effectively used. The incidence of Sexual Dysfunction is up to 80% in men and 72% in women, and treatment focuses on improvement of overall Disability and Erectile or Orgasmic Function.

Conclusions
Although the GenitoUrinary consequences of MS are rarely life threatening, they can cause significant morbidity and patient frustration.

With the rapid advances in the medical management of MS the Urologist should be actively involved in multispecialty treatment of these patients.



Medical Texts
Anatomy | Immune System | Lymphocytes | Meds
MHC | Movement | Cranial Nerves | Physiology


MS Glossary ThJuland's MSers' Glen - Our CyberHome Page Top The Glen's Gallery: Come & Share Our Stories MS Files MS Abstracts Site Index


Abstracts
ANS | Bladder | Cognition | Fatigue | Fluid | Genetics
Interferons | IVIG | Nitric Oxide | Optic Neuritis | Pain
Physiology | Prions | Prognosis | ReMyelinate | Steroids
Stress | Treatments | TNF | Uric Acid | Viruses



Copyright 1997 - 2010:
Permission is granted to MS Societies and all MSers to utilize information from these pages provided that no financial reward is gained and attribution is given to the author/s.