SCOTTSDALE, AZ USA (UroToday.com) - This was a prospective study of patients with multiple sclerosis (MS) that sought to determine a correlation between physical disability and lower urinary tract symptoms (LUTS).
Patients with MS were recruited from outpatient urology practices. Impairment in ambulation was measured using the Kurtzke Expanded Disability Status Scale (EDSS), LUTS by AUA Symptom Score (AUASS), and incontinence by the MESA Incontinence Questionnaire. EDSS score was calculated by a trained neurologist using multiple functional system subscores, including the bowel and bladder sub-score (BBSS). Thirty females and five males (mean age =50) were evaluated. Mean time from MS diagnosis was 14.8 years and from onset of bladder symptoms was 8.5 years. Median EDSS score was 3, corresponding to moderate disability in one functional system or mild disability in 3 or 4 functional systems, though fully ambulatory. Association was seen between EDSS and stress UI and BBSS and stress UI.
The authors conclusions were that LUTS in patients with MS are present at many stages of disability and do not correlate with measures of physical disability. Neither irritative or obstructive LUTS nor UUI correlate with EDSS score, suggesting that urgency-related UI and the need for intermittent catheterization are not independently associated with functional status. There is a moderate association with SUI suggesting decreased pelvic floor muscle strength may accompany physical disability. However, the BBSS of the EDSS may not be a sensitive measure to detect neurogenic bladder dysfunction as no correlation with AUASS or MESA UUI score was seen.
Presented by L. Parrillo, S. Chahin, A. Malykhina, T.Bavaria, D. Newman, A. Wein, and A. Smith at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Divisions of Urology and Neurology, University of Pennsylvania, Philadelphia, PA USA
Reported by Diane K. Newman, DNP, FAAN, BCB-PMD, medical writer for UroToday.com.