Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 3

Neurogenic Bladder in Multiple Sclerosis

Berrin Gündüz 1 ,Belgin Erhan 1 ,Yaprak Demir 2 ,Evrim Coşkun 3 ,Nilgün Tekin 4
1 İstanbul Fiziksel Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye
2 SB 70. Yıl İstanbul Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 1. Klinik, İstanbul
3 Sağlık Bakanlığı 70. Yıl Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi 1. Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
4 70. Yıl Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ürodinami Laboratuvarı, İstanbul

Objective: The aim of this study was to evaluate the neurogenic bladder in patients with multiple sclerosis (MS).

Materials and Methods: Thirty MS patients for more than 6 months duration who were treated as inpatients in the rehabilitation clinic were analyzed retrospectively in terms of demographic characteristics, duration of illness, urinary system symptoms, urination methods, serum urea and creatinine levels, urinary system ultrasonography, videourodynamic evaluation.

Results: The mean age of the patients and mean duration of the illness were 40.8±8.15 years and 8.8±6.15 years, respectively. When the urological symptoms were analyzed 23 of the patients had irritative, 6 had obstructive urological symptoms; 18 patients were suffering from urinary leaks. Only one patient was without an urologic symptom.
In the urinary system ultrasonography 8 patients had bladder trabeculation and 2 had bladder diverticulosis; 6 patients had upper urinary system dilatation, 1 had bladder stone, 1 had cystocele. Serum urea and creatinine levels were normal in all patients.
According to videourodynamic evaluation only 1 patient had stable bladder. Eighteen patients had detrusor overactivity, 9 had detrusor sphincter dyssinergia and detrusor overactivity, 2 had detrusor areflexia. In addition to these findings 8 patients had hypocompliance, 3 had sphincter insufficiency.

Conclusion: Urinary problems should not be omitted in MS patients. Appropriate management should be arranged after neurourological evaluation. 

Keywords : Multiple sclerosis, neurogenic bladder, videourodynamics