Vesicourethral Dysfunction in Multiple Sclerosis

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Abstract
Urodynamic evaluation was done 45 times on 41 consecutive patients with multiple sclerosis. Bladder symptoms correlated poorly with any single urodynamic finding and, accordingly, a comprehensive evaluation was necessary to define the underlying pathophysiology. Only 63% of the patients with symptoms of urgency, frequency and urge incontinence actually had uninhibited bladder contractions, while 73% of the patients with obstructive symptoms had detrustor areflexia. Six patients (15%) had a marked change in urodynamic findings upon repeat examination either because of a change in symptomatology or poor response to treatment. An additional 6 patients had vesicoureteral reflux. Bladder symptoms in multiple sclerosis patients should serve more to alert the clinician to the need for urodynamic testing than to mandate specific treatment.