Chronic Urinary Retention in Multiple Sclerosis Patients: Physiology, Systematic Review of Urodynamic Data, and Recommendations for Care

John T Stoffel

doi:10.1016/j.ucl.2017.04.009

Chronic Urinary Retention in Multiple Sclerosis Patients: Physiology, Systematic Review of Urodynamic Data, and Recommendations for Care

Urol Clin North Am. 2017 Aug;44(3):429-439. doi: 10.1016/j.ucl.2017.04.009.

Author

John T Stoffel¹

Affiliation

¹ Department of Urology, University of Michigan Hospital, University of Michigan, 3875 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address: jstoffel@med.umich.edu.

PMID: 28716323
DOI: 10.1016/j.ucl.2017.04.009

Abstract

Many multiple sclerosis (MS) patients are affected by urinary retention. Common causes include neurogenic underactive bladder and/or bladder outlet obstruction from detrusor sphincter dyssynergia. Systemic review of contemporary MS urodynamic studies demonstrates that 53% of MS patients have detrusor overactivity, 43% have detrusor sphincter dyssynergia, and 12% have atonic bladder (12 studies, 1524 patients). There is no standard definition of MS-related urinary retention, but greater than 300 mL is a proposed threshold value for the condition based on literature review. Treatment should be based on stratifying patients by risk from morbidity from retention and by symptoms caused by retention.

Keywords: Multiple sclerosis; Neurogenic bladder; Urinary retention; Urodynamics.

Publication types

Review
Systematic Review

MeSH terms

Chronic Disease
Humans
Multiple Sclerosis / complications*
Practice Guidelines as Topic
Urinary Retention / diagnosis
Urinary Retention / etiology
Urinary Retention / physiopathology*
Urinary Retention / therapy*
Urodynamics