Tuesday, 29 October 2013

Common Urinary Problems

Urinary tract infections. How involved do you want your neurologist to be in preventing them? #MSBlog #MSResearch

"We had a meeting yesterday to discuss service development and urinary tract problems, in particular urinary tract infections (UTIs) were one of our priorities. Continence services for MS are typically managed by community-based continence advisers, who take on all-comers with bladder and bowel problems. The problem that was highlighted by one of our MS nurses is that MSers often do not take the advice seriously and don't look after their bladders. The debate was how involved should we be in preventing UTIs without undermining the local services. The consensus from the clinical side was very involved. UTIs are major heathcare utilization problem, cause misery to MSers and probably increase the rate of disability progression. I will be posting a lot more on UTI and bladder management in the next few weeks. In the interim please re-read these two clinic speak posts."

16 Aug 2013
Clinic speak: why the bladder is so important to MSers. Bladder dysfunction; is it a problem for you? #MSBlog #MSResearch #ClinicSpeak. Clinical problem: I am 36 years of age and I have developed urinary frequency and ...
06 May 2013
Clinic speak: poor sleep due to bladder overactivity. Do you have night-time bladder problems? This post is for you. #MSBlog #MSResearch "Recently I have focused on sleep problems in MS. One particular problem is ...


Epub: Castel-Lacanal  et al. Urinary complications and risk factors in symptomatic multiple sclerosis patients. Study of a cohort of 328 patients. Neurourol Urodyn. 2013 Sep 23.

AIMS: Lower urinary tract dysfunctions (LUTD) are very common in MSer and have a significant social impact, while the organic impact is discussed. This study looks at urinary complications and their risk factors in our cohort of MSers, in order to improve the management of LUTD in MS.

METHODS: Between 2004 and 2009, all MSers and managed for LUTD were included in a retrospective study. They studied the epidemiological data (age, gender), the clinical data (duration of MS, EDSS score, progression of MS) and the paraclinical data (urinary creatinine clearance, urine culture, urinary tract ultrasonography and in some cases urodynamic assessment and cystography). They then identified the urinary complications and their risk factors.

RESULTS: Three hundred twenty eight MSers , mean age 49.9 ± 12.3 years, with a MS for 14.3 ± 10 years on average and with a median EDSS score equal to 6 (1-9), were managed for LUTD. One hundred seventy eight (54%) MSers developed one or more urinary complications. They identified duration of MS greater than 8.5 years and an EDSS above 7 as risk factors.

CONCLUSION: Urinary complications are common in symptomatic MS, these results imply screening and specialized care to limit the impact on the quality of life but also to prevent urinary complications.

2 comments:

  1. Is there a reason why people with MS get more UTIs? If so, how are they prevented, apart from personal hygiene precautions?

    ReplyDelete
  2. I'm not a doctor, but the MS affects the nerves that the bodies uses to simultaneously open and close the spincters so you can pee. When this doesn't happen as it should, you retain urine in which bacteria grow, and its off to the races. UTI's are dreadful for MS patients. They frequently mimic MS symptoms so accurately that a maladept urologist will send you right back to your neuro. But a good urologist will keep trying things: ellura, vesicare, 4x daily self cath, botox, maybe surgery, e.g., to keep you clear of uti. There is some resarch - more needed - that poses that repeated uti becomes part of the MS disease activity. Nice. Do whatever it takes, remaining uti clear will have massive impact on your MS.

    ReplyDelete

Please note that all comments are moderated and any personal or marketing-related submissions will not be shown.