Published online Nov 24, 2014. doi: 10.5410/wjcu.v3.i3.152
Revised: July 3, 2014
Accepted: July 25, 2014
Published online: November 24, 2014
Multiple sclerosis is a neuroinflammatory condition that can cause significant bladder dysfunction manifesting either as overactive bladder or impaired bladder emptying. Patients will often complain of urgency, frequency, nocturia, urgency incontinence, hesitancy, straining to void, and incomplete bladder emptying. While these symptoms can be treated with pharmacologic agents, often patients will require more significant treatments. Patients should first be evaluated with urodynamics in order to adequately diagnose the pathologic condition causing their symptoms. These interventions include catheter use, injection of botulinum toxin, neuromodulation, urethral stenting, sphincterotomy, suprapubic catheter with bladder neck closure, bladder augmentation and urinary diversion. The purpose of this review is to examine the evidence supporting each of these treatment options so urologic providers can better provide for this unique and complex patient population.
Core tip: Patients with multiple sclerosis can present with a variety of different urologic symptoms. While they can be treated with multiple pharmacologic agents, at times they will require manipulation or surgical intervention. This article reviews the scientific evidence behind each treatment modality so providers may be more informed as they council patients.