Urinary Dysfunction in Women with Multiple Sclerosis: Analysis of 61 Patients from Rio de Janeiro, Brazil

The aim of the present study is to describe the type and frequency of bladder dysfunction in a series of female patients with multiple sclerosis (MS) from Rio de Janeiro, and analyze the role of the urologist in the multidisciplinary team. A team of urologists and a neurologist from the Hospital da Lagoa, Rio de Janeiro, Brazil, interviewed female patients with MS about illness onset, urologic follow-up since diagnosis, current stage of the disease and current urological symptoms. The interview was followed by an urodynamic testing, ultrasound of the urinary tract and urinalysis. Data resulting from the interviews and exam results were gathered and submitted to statistical evaluation. Sixty one patients were evaluated, with average age of 41.4 years. Urinary symptoms such as urinary incontinence, urinary hesitancy, urinary retention, urinary urgency and incomplete bladder emptying were reported in 44% of patients as initial signs of MS disease. Mean disease duration was 8 years and all patients (100%) with the primary progressive form of the disease and 63.5% with the relapsing-remitting presentation had urological symptoms. Analysis of complementary exams showed that 37.7% of urinalysis, 8.2% of the urinary tract ultrasound exams and 66.7% of the urodynamic evaluations were abnormal and the most frequent abnormality were overactive neurogenic bladder. Only 4 patients (6.6%) had seen an urologist during the course of their disease and only 1.6% had performed an urodynamic evaluation. This study shows a high prevalence (68%) of urinary dysfunction in a female population with MS. Urologic care should be part of the multidisciplinary team since the beginning of the disease. An urodynamic evaluation and simple urinalysis should be included in the routine testing during disease follow-up due to the high incidence of neurogenic bladder and other urologic complications.