Presentation Authors: Mohammed Abdelazim, Hisham Torad, Ahmed Abdelaziz*, Hussein Hussein, Nevin Mohieldin Shalaby Shalaby, Samih Sadek, Cairo, Egypt
Introduction: This study aims to assess the natural history, fate and factors affecting urinary symptoms in patients with multiple sclerosis.
Methods: A prospective study of 120 patients diagnosed to have multiple sclerosis (MS) presented to the outpatients clinic in faculty of medicine, Cairo University between October 2016 and septemper 2017. We excluded patients with other urological or neurological diseases. Full history, urological and neurological examination, MRI brain and spinal cord with contrast, abdomen-pelvic ultrasound and urodynamic study were done to all patients. We followed up all the patients for at least one year to detect the progression of urinary symptoms by American Urological Association (AUA) symptoms score and urodynamic study.
Results: The study included 120 patients, 38 males (31.7%) with mean age 35.2Â±10 y. The mean duration of MS was 6.1Â±4.9 y and the mean number of relapses was 4.1Â±2.3. The most common presentation was paraparesis (40%) and least common presentation was depression (1.7%). All patients were suffering from urinary symptoms but cognitive functions were the least to be affected (1.7%). The most commom MRI finding was periventericular lesion (85%). Ninty percent of patients suffered from irritative symptoms, and 51.7% suffered from Obstructive symptoms.The most common urodynamic finding was detrusor overactivities (61.7%) and the 2nd common was detrosur sphincter dysenergia (26,7%) and 10% had normal urodunamic study. All patients received the same neurological treatment protocol and symptomatic treatment for voiding dysfunction. Follow up showed significant improvement of AUA symptoms score and urodynamic criteria in 108 patients (90%). The site of brain lesion was the most significantly affecting factor on the urological symptoms and their improvement as juxstacortical lesion was the most common lesion associated with detruor overactivities and pericallosal lesion is significantly associated with poor prognosis of urinary symptoms. There was no significant effect of age, duration of the disease, number of relapses,first presntation, or type of MS on urinary symptoms or their progression.
Conclusions: Urinary symptoms are prevalent in patients with multiple sclerosis. Site of the lesion is the most predictor factor for urinary symptoms progression with no effect of age, duration of the disease, number of relapses,first presntation, or type of MS on urinary symptoms progression.