Barriers experienced by patients with multiple sclerosis in seeking care for lower urinary tract symptoms

2016 ◽  
Vol 36 (4) ◽  
pp. 1208-1213 ◽  
Author(s):  
Benjamin M. Brucker ◽  
Victor W. Nitti ◽  
Sidhartha Kalra ◽  
Joseph Herbert ◽  
Areeba Sadiq ◽  
...  
2019 ◽  
Author(s):  
Fatemeh Nazari ◽  
Vahid Shaygannejad ◽  
Mehrdad Mohammadi Sichani ◽  
Marjan Mansourian Gharaagozlou ◽  
Valiollah Hajhashemi

Abstract Background Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS. Methods This cross-sectional study was performed on 603 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The sampling was performed by multi-stage random cluster sampling method and the informed consent form was filled in by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS). The data were analyzed using descriptive and inferential statistical tests in SPSS and the significance level was considered to be less than 0.050. Results The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between the two groups of men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between the two groups of women and men in terms of the prevalence of other symptoms (P > 0.050). Moreover, there was a significant difference between the degree of LUTS with age, marital status, education, duration of illness, clinical course, and disability (P < 0.05). Conclusions A high prevalence of LUTS was found among patients with MS, with similar rates in men and women, and the nature of the urinary complaints and LUTS was different among men and women with MS. Therefore, it is recommended that the health system take necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.


2017 ◽  
Vol 11 (3-4) ◽  
pp. 110 ◽  
Author(s):  
Shachar Moshe Aharony ◽  
Ornella Lam ◽  
Jacques Corcos

Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time- and disease course-related. Lower urinary tract symptoms (LUTS) are highly prevalent in this patient population, with approximately 90% showing some degree of voiding dysfunction and/or incontinence 6–8 years after the initial MS diagnosis. Major therapeutic goals include quality of life improvement and the avoidance of urological complications Owing to the wide divergence of clinical symptoms and disease course, evaluation and treatment differ between patients. Treatment must be customized for each patient based on disease phase, patient independence, manual dexterity, social support, and other medical- or MS-related issues. Ablative or irreversible therapies are indicated only when the disease course is stable. In most cases of “safe” bladder, behavioural treatment is considered first-line defense. Antimuscarinic drugs, alone or in combination with intermittent self-catheterization, are currently the mainstay of conservative treatment, and several other medications may help in specific disease conditions. Second-line treatment includes botulinum toxin A injection, neuromodulation, indwelling catheters, and surgery in well-selected cases.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fatemeh Nazari ◽  
Vahid Shaygannejad ◽  
Mehrdad Mohammadi Sichani ◽  
Marjan Mansourian ◽  
Valiollah Hajhashemi

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Kristin Khalaf ◽  
Denise Globe ◽  
Edward Armstrong ◽  
Daniel Malone ◽  
Karin Coyne

2019 ◽  
Author(s):  
Fatemeh Nazari ◽  
Vahid Shaygannejad ◽  
Mehrdad Mohammadi Sichani ◽  
Marjan Mansourian Gharaagozlou ◽  
Valiollah Hajhashemi

Abstract Evaluation of Quality of Life among Patients with Multiple Sclerosis and Lower Urinary Tract Symptoms: A Cross-Sectional Study Background: Urinary complications are prevalent among patients with multiple sclerosis (MS), and evaluating the usefulness of treatment requires a direct measurement of the health-related quality of life (QOL). Therefore, this study was carried out aiming to determine the QOL of patients with MS and lower urinary tract symptoms (LUTS). Methods: This cross-sectional study was carried out using multi-stage random cluster sampling method on 603 patients with MS who referred to the neurology clinic of Kashani and Alzahra treatment centers affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The diagnosis of MS was approved among these patients based on the 2010 Revised McDonald Diagnostic Criteria by a neuroscientist. Data were collected through interviews using the questionnaire standard International Prostate Symptom Score (IPSS), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Data were analyzed using descriptive and inferential statistical tests. The significance level was considered to be less than 0.050. Results: The prevalence of LUTS among patients with MS was 84.2%, the prevalence rate of mixed, irritative, and obstructive urinary symptoms was 52.2%, 25.5%, and 6.5%, respectively. There was a statistically significant difference in the combined dimensions of physical and mental health of QOL between the two groups with and without LUTS (P < 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary tract problem among patients with MS and high EDSS score [0.67 (0.485-0.930), P = 0.02]. Conclusions: Due to the high prevalence rate of mixed LUTS among patients with MS and decrease in QOL, screening and attention to these symptoms are necessary in order to prevent secondary outcomes and improve QOL. Keywords: Multiple sclerosis, urinary symptoms, quality of life


2019 ◽  
Author(s):  
Fatemeh Nazari ◽  
Vahid Shaygannejad ◽  
Mehrdad Mohammadi Sichani ◽  
Marjan Mansourian Gharaagozlou ◽  
Valiollah Hajhashemi

Abstract Background: Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS. Methods: This cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS. Results: The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P < 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507-0.903), P = 0.008]. Conclusions: A high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS. Keywords: Multiple sclerosis, prevalence, urinary symptoms


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