Historical and Current Concepts Regarding Urodynamics in Multiple Sclerosis Patients

Jennifer Rothschild, Chris Weichen Xu

Research output: Contribution to journalReview article

Abstract

Purpose of Review: In this review, current literature on management of neurogenic bladder in patients with multiple sclerosis (MS) is summarized. Topics include a review of MS, a brief overview of general treatment options, the effects of MS may manifest on lower urinary tract symptoms (LUTS), and clinical assessment of these patients. The utility of urodynamic evaluation in this patient population and the use of antibiotic prophylaxis in patients with MS on immunomodulatory medications are reviewed. Recent Findings: Unlike neurogenic bladder in spinal cord patients, lower urinary tract dysfunction in MS patients rarely leads to upper urinary tract deterioration. Currently there is no consensus on imaging as a screening tool to assess renal deterioration in this patient population. Internationally, there are differing opinions on the necessity of performing invasive urodynamic (UDS) investigation in MS patients during initial assessment. However, UDS evaluation can be useful in the guidance of treatment options and patient counseling and prior to more invasive interventions. Summary: Depending on the severity of MS, lower urinary tract symptoms are common and can evolve with progression of the disease. Although individual guidelines exist for management of patients with MS and select aspects of neurogenic LUTS, an optimal guideline for initial evaluation and surveillance is not available. The evaluation of patients with MS reporting LUTS should be uniquely tailored and take into consideration individual symptoms, disease course, comorbidities, and medications. Additionally, MS patients on immunomodulation medications that undergo UDS should be considered for prophylactic antibiotics.

Original languageEnglish (US)
JournalCurrent Bladder Dysfunction Reports
DOIs
StatePublished - Jan 1 2019

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Urodynamics
Multiple Sclerosis
Deterioration
Anti-Bacterial Agents
Lower Urinary Tract Symptoms
Screening
Imaging techniques
Neurogenic Urinary Bladder
Urinary Tract
Guidelines
Symptom Assessment
Immunomodulation
Antibiotic Prophylaxis
Population
Disease Progression
Comorbidity
Counseling
Spinal Cord
Consensus

Keywords

  • Lower urinary tract symptoms
  • Multiple sclerosis
  • Neurogenic bladder
  • Overactive bladder
  • Urinary incontinence
  • Urinary retention
  • Urodynamic evaluation

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology

Cite this

Historical and Current Concepts Regarding Urodynamics in Multiple Sclerosis Patients. / Rothschild, Jennifer; Xu, Chris Weichen.

In: Current Bladder Dysfunction Reports, 01.01.2019.

Research output: Contribution to journalReview article

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abstract = "Purpose of Review: In this review, current literature on management of neurogenic bladder in patients with multiple sclerosis (MS) is summarized. Topics include a review of MS, a brief overview of general treatment options, the effects of MS may manifest on lower urinary tract symptoms (LUTS), and clinical assessment of these patients. The utility of urodynamic evaluation in this patient population and the use of antibiotic prophylaxis in patients with MS on immunomodulatory medications are reviewed. Recent Findings: Unlike neurogenic bladder in spinal cord patients, lower urinary tract dysfunction in MS patients rarely leads to upper urinary tract deterioration. Currently there is no consensus on imaging as a screening tool to assess renal deterioration in this patient population. Internationally, there are differing opinions on the necessity of performing invasive urodynamic (UDS) investigation in MS patients during initial assessment. However, UDS evaluation can be useful in the guidance of treatment options and patient counseling and prior to more invasive interventions. Summary: Depending on the severity of MS, lower urinary tract symptoms are common and can evolve with progression of the disease. Although individual guidelines exist for management of patients with MS and select aspects of neurogenic LUTS, an optimal guideline for initial evaluation and surveillance is not available. The evaluation of patients with MS reporting LUTS should be uniquely tailored and take into consideration individual symptoms, disease course, comorbidities, and medications. Additionally, MS patients on immunomodulation medications that undergo UDS should be considered for prophylactic antibiotics.",
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