MS and its associated bladder symptoms have a considerable negative impact on patients' quality of life and, although progression of the neurological disease is proving difficult to halt, much can now be done to improve bladder control. Intermittent self-catheterization can make a crucial difference to management of patients in whom incomplete voiding is contributing to bladder dysfunction. The development of more selective oral agents is to be welcomed, as is the exciting discovery of intradetrusor botulinum neurotoxin injections to treat severely affected patients. Surgery has comparatively less to offer, and effective management is becoming possible largely as an outpatient procedure. Many patients' bladder problems are now being managed in the same clinic as cares for their underlying neurological disease, although urologic invention might still be necessary to deal with stone formation, recurrent infections and placement of a suprapubic catheter.
Overall, the options for bladder management in MS have improved greatly, and more patients are able to receive effective treatment for very distressing symptoms that would otherwise compound their neurological disability.
PubMed was searched for articles published from January 1965 to March 2005 using the terms "multiple sclerosis", "bladder", and "incontinence". Additional papers were also obtained from the bibliographies of selected articles. The selection of papers was based on relevance on subject matter, clinical importance and scientific value.
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Correspondence: Clare J. Fowler, Department of Uro-Neurology, Internal mailbox 71, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. Email: email@example.com
Nat Clin Pract Urol. 2005;2(10):492-501. © 2005
Nature Publishing Group
Cite this: Therapy Insight: Bladder Dysfunction Associated With Multiple Sclerosis - Medscape - Oct 01, 2005.