Multiple Sclerosis (MS) manifests with a plethora of signs and symptoms affecting brain structures and spinal pathways. The multitude of lesions in MS patients makes difficult to establish the relative role of each of them to lower urinary tract symptoms (LUTS). Generally, the subcortical white-matter lesions result in detrusor overactivity, whilst lesions of the spinal cord result in the combined occurrence of detrusor overactivity and detrusor-sphincter dyssynergia (DSD). It has been estimated that 80-90% of patients with MS will suffer from some form of LUTS over the course of the disease. Among LUTS, the most reported is detrusor overactivity which includes urinary urgency, frequent urination, nocturia, and urge urinary incontinence.
The authors review the management of lower urinary tract symptoms in MS patients providing their expert opinions on the subject matter.
LUTS affect the quality of life substantially and are associated with a significantly increased mortality. The adequate management is an important challenge for both patients and caregivers with a multidisciplinary approach likely necessary.
Expert opinion on pharmacotherapy. 2020 May 26 [Epub ahead of print]
Aurora Zanghì, Sebastiano Cimino, Daniele Urzì, Salvatore Privitera, Francesco Zagari, Giuseppe Lanza, Francesco Patti, Emanuele D'Amico
Department G.F.Ingrassia, University of Catania , Catania, Italy., Department of Surgery and Medical-Surgical Specialties, University of Catania , Catania, Italy., AOU Policlinico G.Rodolico, Catania, Italy.