Micturition disorders in multiple sclerosis patients: Neurological, neurourodynamic and magnetic resonance findings

Micturition disorders are frequent in an advanced course of multiple sclerosis. Historical records of multiple sclerosis patients reveal that urinary symptoms occur with high frequence. In the present study we have investigated all patients who were admitted to our Multiple Sclerosis Center in a 1 year period. All patients underwent a neurological examination corroborated by MRI investigation. Out of 101 patients, 75 who reported urinary symptoms, underwent neurourodynamic investigation. Sixty of them exhibited functional micturition abnormalities, which were strictly correlated to EDSS, pyramidal and cerebellar functional statuses scores. Detrusor hyperreflexia was the commonest abnormality. Neurourodynamic findings were also correlated to the burden of lesion, although MRI seems to fail in localizing specific neural pathways which control micturition phases. Moreover, urodynamic evaluation can select different groups of MS patients with different degrees of neurological impairment.