Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment.
OBJECTIVE
To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey.


METHODS
Survey study.


METHODS
Outpatient tertiary clinics of physical medicine and rehabilitation and neurology.


METHODS
Consecutive MS patients scheduled for outpatient follow-up (n = 309).


METHODS
MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems.


RESULTS
The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002).


CONCLUSIONS
Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.
a Department of Physical Medicine and Rehabilitation , Ege University Faculty of Medicine , Bornova - İzmir , Turkey.
Yeşim
Y
Akkoç
b Department of Physical Medicine and Rehabilitation , Ankara Physical Medicine and Rehabilitation Education and Research Hospital , Ankara , Turkey.
Murat
M
Ersöz
c Department of Neurology , Ege University Faculty of Medicine , Bornova - İzmir , Turkey.
Nur
N
Yüceyar
b Department of Physical Medicine and Rehabilitation , Ankara Physical Medicine and Rehabilitation Education and Research Hospital , Ankara , Turkey.
Hakan
H
Tunç
b Department of Physical Medicine and Rehabilitation , Ankara Physical Medicine and Rehabilitation Education and Research Hospital , Ankara , Turkey.
Kurtuluş
K
Köklü
d Department of Neurology , Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital , Ankara , Turkey.
Tahir Kurtuluş
TK
Yoldaş
a Department of Physical Medicine and Rehabilitation , Ege University Faculty of Medicine , Bornova - İzmir , Turkey.
Ülkü
Ü
Dönmez
c Department of Neurology , Ege University Faculty of Medicine , Bornova - İzmir , Turkey.
Cihat
C
Uzunköprü
b Department of Physical Medicine and Rehabilitation , Ankara Physical Medicine and Rehabilitation Education and Research Hospital , Ankara , Turkey.
Ebru
E
Alemdaroğlu
e Department of Neurology , Ankara Numune Training and Research Hospital , Ankara , Turkey.
Şule
Ş
Bilen
f Department of Neurology , Bulent Ecevit University Faculty of Medicine , Zonguldak , Turkey.
Ufuk
U
Emre
g Department of Physical Medicine and Rehabilitation , Bulent Ecevit University Faculty of Medicine , Zonguldak , Turkey.
Şenay
Ş
Özdolap
h Department of Neurology , Ankara University Faculty of Medicine , Ankara , Turkey.
Elif
E
Tuncay
h Department of Neurology , Ankara University Faculty of Medicine , Ankara , Turkey.
Canan
C
Yücesan
i Department of Physical Medicine and Rehabilitation , Ankara University Faculty of Medicine , Ankara , Turkey.
Haydar
H
Gök
j Department of Neurology , Gazi University Faculty of Medicine , Ankara , Turkey.
Merve Bahar
MB
Ercan
k Department of Physical Medicine and Rehabilitation , Gazi University Faculty of Medicine , Ankara , Turkey.
Kürşat
K
Uygunol
j Department of Neurology , Gazi University Faculty of Medicine , Ankara , Turkey.
Belgin
B
Koçer
k Department of Physical Medicine and Rehabilitation , Gazi University Faculty of Medicine , Ankara , Turkey.
Murat
M
Zinnuroğlu
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D014546:Urinary Catheterization / Q000379:methods; D014563:Urodynamics
Indwelling catheterization; Intermittent catheterization; Multiple sclerosis; Neurogenic bladder; Urinary symptom