title: The impact of pontine disease on lower urinary tract symptoms in patients with multiple sclerosis.
abstract: To investigate the relationship between pontine lesion characteristics on MRI and lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS).
  
  
  
  We performed a prospective cohort study of patients with MS and LUTS who were undergoing brain/spine MRI. Patients were administered the American Urological Association Symptom Score (AUA-SS), Medical, Epidemiologic, and Social Aspects of Aging questionnaire (MESA), and Urogenital Distress Inventory questionnaire (UDI-6), underwent Kurtzke Expanded Disability Status Scale (EDSS) scoring by a neurologist, and had their MRIs reviewed by a neuroradiologist. The relationships between symptom scores and lesion number, size, and location were analyzed.
  
  
  
  There were 42 patients that completed the study and 20 (48%) had one or more pontine lesions. Total AUA-SS and UDI-6 were related to multiple Short Form Health Survey (SF-36) scales and not EDSS scoring. Weak urinary stream measured on the AUA-SS (P = 0.028), and urgency incontinence measured on the MESA questionnaire (P = 0.034) were related to pontine lesion diameter. There was no difference in urinary symptoms according to the presence or absence of a pontine lesion, or according to lesion location within the pons.
  
  
  
  Pontine lesion size appears to be related to lower urinary tract symptoms (weak stream and urgency incontinence) in patients with MS. Therefore, CNS lesion characteristics may be able to phenotype voiding symptoms in patients with MS. Neurourol. Urodynam. 36:453-456, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weissbart
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Dasha
authors.initials: D
authors.lastname: Pechersky
authors.affiliation: Division of Urology, Department of Surgery, University of Colorado, Aurora, Colorado.
authors.forename: Anna
authors.initials: A
authors.lastname: Malykhina
authors.affiliation: Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bavaria
authors.affiliation: Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Lisa
authors.initials: L
authors.lastname: Parrillo
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Lily A
authors.initials: LA
authors.lastname: Arya
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Michel
authors.initials: M
authors.lastname: Bilello
authors.affiliation: Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.affiliation: Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Ariana L
authors.initials: AL
authors.lastname: Smith
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology*; D011149:Pons / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: magnetic resonance imaging; multiple sclerosis; neurogenic bladder