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The impact of pontine disease on lower urinary tract symptoms in patients with multiple sclerosis
Author(s) -
Weissbart Steven J.,
Pechersky Dasha,
Malykhina Anna,
Bavaria Thomas,
Parrillo Lisa,
Arya Lily A.,
Bilello Michel,
Wein Alan J.,
Smith Ariana L.
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22953
Subject(s) - medicine , multiple sclerosis , lesion , urinary system , urinary incontinence , expanded disability status scale , lower urinary tract symptoms , pons , urology , surgery , prostate , psychiatry , cancer
Aims To investigate the relationship between pontine lesion characteristics on MRI and lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS). Methods We performed a prospective cohort study of patients with MS and LUTS who were undergoing brain/spine MRI. Patients were administered the American Urological Association Symptom Score (AUA‐SS), Medical, Epidemiologic, and Social Aspects of Aging questionnaire (MESA), and Urogenital Distress Inventory questionnaire (UDI‐6), underwent Kurtzke Expanded Disability Status Scale (EDSS) scoring by a neurologist, and had their MRIs reviewed by a neuroradiologist. The relationships between symptom scores and lesion number, size, and location were analyzed. Results There were 42 patients that completed the study and 20 (48%) had one or more pontine lesions. Total AUA‐SS and UDI‐6 were related to multiple Short Form Health Survey (SF‐36) scales and not EDSS scoring. Weak urinary stream measured on the AUA‐SS ( P = 0.028), and urgency incontinence measured on the MESA questionnaire ( P = 0.034) were related to pontine lesion diameter. There was no difference in urinary symptoms according to the presence or absence of a pontine lesion, or according to lesion location within the pons. Conclusions Pontine lesion size appears to be related to lower urinary tract symptoms (weak stream and urgency incontinence) in patients with MS. Therefore, CNS lesion characteristics may be able to phenotype voiding symptoms in patients with MS. Neurourol. Urodynam. 36:453–456, 2017 . © 2016 Wiley Periodicals, Inc.