Neurogenic lower urinary tract dysfunction (LUTD) results in lower urinary tract symptoms (LUTS) that impact quality of life in people with multiple sclerosis (PwMS). The risk factors and the contribution of LUTD to multiple sclerosis (MS) disease progression are under-researched.
To identify clinical and demographic predictors of LUTS in PwMS and gaps in clinical ascertainment.
Participants were adults with MS enrolled in a prospective, multicenter study (SUMMIT, N=802), including a subset of N = 258 patients in the UCSF EPIC study for whom medical records were further reviewed. Demographic (age, sex, race, ethnicity), clinical (disease duration, MS type), and female-specific reproductive factors (e.g., parity) were evaluated to determine associations with bowel/bladder functional system scores. Participants' medical records were analyzed to understand the patterns of LUTS ascertainment by physicians and the specific contribution of LUTS to overall bowel/bladder functional system scores.
802 participants (71.3% female) contributed to these analyses. Higher bowel/bladder functional system scores, indicating worsening symptoms and function, were significantly associated with female sex (p=0.001) and progressive MS type (p≤ 0.001). In the EPIC participants, female-specific reproductive exposures (parity, menopause) were not significantly associated with worse bowel/bladder functional system scores. Most (98%) bowel/bladder functional system scores reflected the severity of LUTS (relative to bowel dysfunction). LUTS were under-ascertained clinically, and more so in women (X2 = 5.02, p=0.08).
Female sex and MS type are predictive of worsening LUTS. Symptoms may be less likely to be ascertained by clinicians in females compared to males.
Multiple sclerosis and related disorders. 2022 Apr 11 [Epub ahead of print]
Tamara B Kaplan, Arpita Gopal, Valerie J Block, Anne M Suskind, Chao Zhao, Mariann Polgar-Turcsanyi, Taylor J Saraceno, Refujia Gomez, Adam Santaniello, Summit Consortium, Nabil El Ayoubi, Bruce A C Cree, Stephen L Hauser, Howard Weiner, Tanuja Chitnis, Samia Khoury, Riley Bove
Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA., UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA., UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; UCSF Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA., UCSF Department of Urology, University of California, San Francisco, San Francisco, CA, USA., Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA., UCSF Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA., Nehme and Therese Tohme Multiple Sclerosis (MS) Center, American University of Beirut Medical Center, Beirut, Lebanon., UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA. Electronic address: .