title: Assessment of a program to encourage the multidisciplinary management of urinary disorders in multiple sclerosis.
abstract: Urinary disorders (UD) secondary to multiple sclerosis (MS) are common and can be responsible for complications. Since 2004, we organized in our region their management through a neuro-urological activity and a care network that established and distributed an algorithm for screening and first line care. The objective was to assess the effects of this organization on the management of UD and its impact for patients.
  
  
  
  Between January 2004 and December 2009, 328 patients were seen in neuro-urological consultation. The data of a group of 168 patients consulting during the deployment of our organization (before January 2007: group 1) were compared to those of 160 patients taken when the organization was well established (from January 2007: group 2). In parallel, the modification of the prescription rate of the first-line examination patients was evaluated.
  
  
  
  The two groups were significantly different concerning age, duration of MS, EDSS score (Group 1 vs. Group 2 respectively 51.6 ± 12.6 vs. 48 ± 11.8 years, P = 0.008; 19 ± 9.7 vs. 13.8 ± 10.5 years, P < 0.0001; 5.8 ±2.0 vs. 5.1 ± 2.1, P = 0.008). The occurrence of urinary complications in group 1 was more frequent than in group 2 (66.3% vs. 40%, P < 0.0001). The rate of first-line examinations rose from 1/16 patient seen in January 2006 to 9/12 patients in January 2008.
  
  
  
  The multidisciplinary management of UD in MS led to patients being cared for sooner in the evolution of MS, with fewer complications and to an improvement in the rate of prescription of first-line examinations. Neurourol. Urodynam. 36:706-709, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Service de médecine physique et réadaptation, CHU Toulouse, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Castel-Lacanal
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, CHU Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.affiliation: Service de neurologie, CHU Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Clanet
authors.affiliation: Service de médecine physique et réadaptation, CHU Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: De Boissezon
authors.affiliation: Service de neurologie, CHU Toulouse, France.
authors.forename: David
authors.initials: D
authors.lastname: Brassat
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, CHU Toulouse, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
authors.affiliation: Service de médecine physique et réadaptation, CHU Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Marque
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D015397:Program Evaluation; D012189:Retrospective Studies; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy*; D055815:Young Adult
keywords: multidisciplinary management; multiple sclerosis; neurogenic bladder; urinary complications