Clinical Predictors of Neurogenic Lower Urinary Tract Dysfunction in Persons with Multiple Sclerosis.
Expanded Disability Status Scale (EDSS)
bladder diary (BD)
multiple sclerosis (MS)
neuro-urology
neurogenic lower urinary tract dysfunction (NLUTD)
post-void residual (PVR)
prospective study
upper urinary tract damage (UUTD)
Journal
Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402
Informations de publication
Date de publication:
13 Jan 2022
13 Jan 2022
Historique:
received:
30
11
2021
revised:
05
01
2022
accepted:
11
01
2022
entrez:
21
1
2022
pubmed:
22
1
2022
medline:
22
1
2022
Statut:
epublish
Résumé
Multiple sclerosis patients often develop neurogenic lower urinary tract dysfunction with a potential risk of upper urinary tract damage. Diagnostic tools are urodynamics, bladder diary, uroflowmetry, and post-void residual, but recommendations for their use are controversial. We aimed to identify clinical parameters indicative of neurogenic lower urinary tract dysfunction in multiple sclerosis patients. 207 patients were prospectively assessed independent of the presence of lower urinary tract symptoms. We analyzed Expanded Disability Status Scale scores, uroflowmetry, post-void residual, rate of urinary tract infections, standardized voiding frequency, and voided volume in correlation with urodynamic findings. We found a significant correlation between post-void residual (odds ratio (OR) 4.17, confidence interval (CI) 1.20-22.46), urinary tract infection rate (OR 3.91, CI 1.13-21.0), voided volume (OR 4.53, CI 1.85-11.99), increased standardized voiding frequency (OR 7.40, CI 2.15-39.66), and urodynamic findings indicative of neurogenic lower urinary tract dysfunction. Expanded Disability Status Scale shows no correlation. Those parameters (except post-void residual) are also associated with reduced bladder compliance, as potential risk for kidney damage. Therefore, bladder diary and urinary tract infection rate should be routinely assessed to identify patients who require urodynamics.
Sections du résumé
BACKGROUND
BACKGROUND
Multiple sclerosis patients often develop neurogenic lower urinary tract dysfunction with a potential risk of upper urinary tract damage. Diagnostic tools are urodynamics, bladder diary, uroflowmetry, and post-void residual, but recommendations for their use are controversial.
OBJECTIVE
OBJECTIVE
We aimed to identify clinical parameters indicative of neurogenic lower urinary tract dysfunction in multiple sclerosis patients.
METHODS
METHODS
207 patients were prospectively assessed independent of the presence of lower urinary tract symptoms. We analyzed Expanded Disability Status Scale scores, uroflowmetry, post-void residual, rate of urinary tract infections, standardized voiding frequency, and voided volume in correlation with urodynamic findings.
RESULTS
RESULTS
We found a significant correlation between post-void residual (odds ratio (OR) 4.17, confidence interval (CI) 1.20-22.46), urinary tract infection rate (OR 3.91, CI 1.13-21.0), voided volume (OR 4.53, CI 1.85-11.99), increased standardized voiding frequency (OR 7.40, CI 2.15-39.66), and urodynamic findings indicative of neurogenic lower urinary tract dysfunction. Expanded Disability Status Scale shows no correlation. Those parameters (except post-void residual) are also associated with reduced bladder compliance, as potential risk for kidney damage.
CONCLUSION
CONCLUSIONS
Therefore, bladder diary and urinary tract infection rate should be routinely assessed to identify patients who require urodynamics.
Identifiants
pubmed: 35054358
pii: diagnostics12010191
doi: 10.3390/diagnostics12010191
pmc: PMC8774871
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : 'Förderverein zur Kontinenzforschung und Kontinenzaufklärung e. V'.; Karmeliterhöfe, Karmeliterstr. 10, 52064 Aachen, Germany. (Grant No 17/002)
ID : 17/002
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