Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

Abstract

To assess the association between objective bladder function parameters in relation to urinary symptoms, and to analyze the sensitivity and specificity of subjective urinary symptom-assessment in predicting objective bladder dysfunction in a multiple sclerosis (MS) population. Consecutive MS patients with Expanded Disability Status Score (EDSS) ≤7.0 were included in this prospective study. In a single visit, patients were evaluated for the presence of urinary symptoms, then assessed for the following urological parameters: maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and detrusor sphincter dyssinergia (DSD). One hundred nine subjects were included with a mean disease duration of 12.5 ± 8.7 years, 90.8% had a relapsing-remitting course; the mean EDSS score was 2.6 ± 1.7. Overall, 53.5% complained of at least one urinary symptom, and the most reported one was urgency (40.7%), followed by frequency (15.7%) and incomplete emptying (12.0%). Abnormal values were found for Qmax in 34.9%, for PVR in 40.4% of participants; DSD was diagnosed in 33.9% of the cases. Only Qmax was found negatively associated with the EDSS score (p = 0.007), but no other association was observed. The presence of urinary symptoms was poor predictor of bladder dysfunction, urgency among the others showed relatively higher predicting value. Subjective urinary symptoms assessment failed in predicting bladder function. Our results confirmed the value of objective urological assessment in patients with MS, irrespective of the presence of urinary symptoms.