title: [Multiple sclerosis and pelviperineology: Urinary and sexual dysfunctions and pregnancy].
abstract: OBJECTIVE
  The aim was to review the literature on genito-urinary dysfunction in multiple sclerosis (MS).
  
  
  METHODS
  A literature review through the PubMed library until August, 31 2013 was carried out using the following keywords: multiple sclerosis and neurogenic bladder, neuropathic bladder, bladder, management, follow-up, urological complications, urological treatment, sexual dysfunction, female sexual function, male sexual function, erectile dysfunction, anorectal, faecal, constipation, bowel, pregnancy, parturition, delivery, breast-feeding.
  
  
  RESULTS
  Genito-urinary dysfunction is frequent in MS (35-90%) and may happen soon in the disease. Urinary symptoms (10-90%) are manifold resulting in a quality of life alteration and the onset of complications in 30% of the cases requiring a long-term follow-up. Sexual dysfunctions (35-87%) are also manifold affecting all the sexuality domains in men and women. Except the phosphodiesterase V inhibitors, few treatments have been assessed in this population. Pregnancy is nowadays considered as beneficial resulting in a disease slow-down and the lack of disease worsening despite an increase in disease relapse during the post-partum first quarter. It seems to be better to consider getting pregnant after at least one year without any relapse and to emphasize an exclusive breast-feeding.
  
  
  CONCLUSIONS
  Urinary and sexual dysfunctions are frequent in MS. A transdisciplinary approach including the neurologist and pelviperineology specialists facilitates a disability adapted early management.
authors.affiliation: Cabinet de neurourologie, urodynamique et pelvipérinéologie, clinique Saint-Augustin, 33000 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: de Sèze
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France. Electronic address: xaviergame@hotmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Gamé
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002186:Cannabinoids / Q000627:therapeutic use; D003559:Cystostomy; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D005260:Female; D052776:Female Urogenital Diseases / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology* / Q000628:therapy; D009103:Multiple Sclerosis / Q000150:complications* / Q000628:therapy; D009498:Neurotoxins / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011788:Quality of Life; D012307:Risk Factors; D018689:Sensory System Agents / Q000627:therapeutic use; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000628:therapy; D015607:Stents; D014546:Urinary Catheterization; D014563:Urodynamics
chemical_list: D000317:Adrenergic alpha-Antagonists; D002186:Cannabinoids; D009498:Neurotoxins; D058986:Phosphodiesterase 5 Inhibitors; D018689:Sensory System Agents; D019274:Botulinum Toxins, Type A
keywords: Bladder; Grossesse; Maternity; Maternité; Multiple sclerosis; Pelviperineology; Pelvipérinéologie; Pregnancy; Sclérose en plaques; Sexuality; Sexualité; Vessie