Mechanisms and current treatments of urogenital dysfunction in multiple sclerosis.

The majority of patients with multiple sclerosis (MS) suffer from lower urinary tract symptoms and sexual dysfunction at some stage of the disease. This has a negative impact on the quality of life of patients as well as causing concern to caregivers and family. Neurologists can now treat most of these symptoms by a number of pharmacological and nonpharmacological methods. This review presents the neuroanatomy, neurophysiology, neuropharmacology and pathophysiology of the urinary bladder and sexual organs, and the biological mechanisms underlying urogenital dysfunction in MS patients. Current treatment options for urinary and sexual dysfunction are reviewed. As most urogenital symptoms of MS can now be treated by conservative means, expert urological or gynaecological consultation should be requested only if more aggressive diagnostic or therapeutic measures are needed.