What are the urologic manifestations of multiple sclerosis?

Updated: Dec 27, 2018
  • Author: Frances M Dyro, MD; Chief Editor: Robert A Egan, MD  more...
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Answer

Answer

Multiple sclerosis (MS) is a disorder that affects patients in many different ways, depending on the part of the neuraxis involved in the demyelinating process. About 10% of patients present with bladder or sexual symptoms, and 65-90% have genital involvement at some time in the course of their disease. These complaints may involve incontinence, urgency, retention, or impotence.

Electromyography (EMG) of the urethral sphincter seldom shows a significant abnormality. Eardley et al studied 24 patients and found only minor abnormalities (eg, abnormalities in central sensory and motor conduction) in 88%. [32]

Mathers et al studied 23 patients with MS and bladder or rectal dysfunction using cortical and lumbar transcutaneous electrical stimulation, pudendal nerve stimulation, single-fiber EMG, and manometry; they found central conduction times to be abnormal in 10 and absent in 8. [25] Peripheral conduction was decreased, and fiber density was increased in 3.

Mayo and Chetner studied 46 women and 43 men with MS aged 22-71 years and found that detrusor abnormalities were extremely common, with 63% failing to empty completely because of hypocontractile bladders and 6% with complete areflexia. [33]


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