M de Sèze1, X Gamé2. 1. Cabinet de neurourologie, urodynamique et pelvipérinéologie, clinique Saint-Augustin, 33000 Bordeaux, France. 2. Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France. Electronic address: xaviergame@hotmail.com.
Abstract
GOAL: The aim was to review the literature on genito-urinary dysfunction in multiple sclerosis (MS). MATERIAL: A literature review through the PubMed library until August, 31 2013 was carried out using the following keywords: multiple sclerosis and neurogenic bladder, neuropathic bladder, bladder, management, follow-up, urological complications, urological treatment, sexual dysfunction, female sexual function, male sexual function, erectile dysfunction, anorectal, faecal, constipation, bowel, pregnancy, parturition, delivery, breast-feeding. RESULTS: Genito-urinary dysfunction is frequent in MS (35-90%) and may happen soon in the disease. Urinary symptoms (10-90%) are manifold resulting in a quality of life alteration and the onset of complications in 30% of the cases requiring a long-term follow-up. Sexual dysfunctions (35-87%) are also manifold affecting all the sexuality domains in men and women. Except the phosphodiesterase V inhibitors, few treatments have been assessed in this population. Pregnancy is nowadays considered as beneficial resulting in a disease slow-down and the lack of disease worsening despite an increase in disease relapse during the post-partum first quarter. It seems to be better to consider getting pregnant after at least one year without any relapse and to emphasize an exclusive breast-feeding. CONCLUSION: Urinary and sexual dysfunctions are frequent in MS. A transdisciplinary approach including the neurologist and pelviperineology specialists facilitates a disability adapted early management.
GOAL: The aim was to review the literature on genito-urinary dysfunction in multiple sclerosis (MS). MATERIAL: A literature review through the PubMed library until August, 31 2013 was carried out using the following keywords: multiple sclerosis and neurogenic bladder, neuropathic bladder, bladder, management, follow-up, urological complications, urological treatment, sexual dysfunction, female sexual function, male sexual function, erectile dysfunction, anorectal, faecal, constipation, bowel, pregnancy, parturition, delivery, breast-feeding. RESULTS: Genito-urinary dysfunction is frequent in MS (35-90%) and may happen soon in the disease. Urinary symptoms (10-90%) are manifold resulting in a quality of life alteration and the onset of complications in 30% of the cases requiring a long-term follow-up. Sexual dysfunctions (35-87%) are also manifold affecting all the sexuality domains in men and women. Except the phosphodiesterase V inhibitors, few treatments have been assessed in this population. Pregnancy is nowadays considered as beneficial resulting in a disease slow-down and the lack of disease worsening despite an increase in disease relapse during the post-partum first quarter. It seems to be better to consider getting pregnant after at least one year without any relapse and to emphasize an exclusive breast-feeding. CONCLUSION: Urinary and sexual dysfunctions are frequent in MS. A transdisciplinary approach including the neurologist and pelviperineology specialists facilitates a disability adapted early management.
Authors: Benoit Peyronnet; Lauren B Krupp; W Stuart Reynolds; Xavier Gamé; Gérard Amarenco; Jean-Nicolas Cornu; Lana Zhovtis Ryerson; Carrie Lyn Sammarco; Jonathan E Howard; Robert W Charlson; Roger R Dmochowski; Benjamin M Brucker Journal: Rev Urol Date: 2019