Yeşim Akkoç1, Murat Ersöz2, Nur Yüceyar3, Hakan Tunç2, Kurtuluş Köklü2, Tahir Kurtuluş Yoldaş4, Ülkü Dönmez1, Cihat Uzunköprü3, Ebru Alemdaroğlu2, Şule Bilen5, Ufuk Emre6, Şenay Özdolap7, Elif Tuncay8, Canan Yücesan8, Haydar Gök9, Merve Bahar Ercan10, Kürşat Uygunol11, Belgin Koçer10, Murat Zinnuroğlu11. 1. a Department of Physical Medicine and Rehabilitation , Ege University Faculty of Medicine , Bornova - İzmir , Turkey. 2. b Department of Physical Medicine and Rehabilitation , Ankara Physical Medicine and Rehabilitation Education and Research Hospital , Ankara , Turkey. 3. c Department of Neurology , Ege University Faculty of Medicine , Bornova - İzmir , Turkey. 4. d Department of Neurology , Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital , Ankara , Turkey. 5. e Department of Neurology , Ankara Numune Training and Research Hospital , Ankara , Turkey. 6. f Department of Neurology , Bulent Ecevit University Faculty of Medicine , Zonguldak , Turkey. 7. g Department of Physical Medicine and Rehabilitation , Bulent Ecevit University Faculty of Medicine , Zonguldak , Turkey. 8. h Department of Neurology , Ankara University Faculty of Medicine , Ankara , Turkey. 9. i Department of Physical Medicine and Rehabilitation , Ankara University Faculty of Medicine , Ankara , Turkey. 10. j Department of Neurology , Gazi University Faculty of Medicine , Ankara , Turkey. 11. k Department of Physical Medicine and Rehabilitation , Gazi University Faculty of Medicine , Ankara , Turkey.
Abstract
OBJECTIVE: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. DESIGN: Survey study. SETTING: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. PARTICIPANTS: Consecutive MS patients scheduled for outpatient follow-up (n = 309). INTERVENTION: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. RESULTS: The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002). CONCLUSION: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.
OBJECTIVE: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. DESIGN: Survey study. SETTING:Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. PARTICIPANTS: Consecutive MSpatients scheduled for outpatient follow-up (n = 309). INTERVENTION: MSpatients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. RESULTS: The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002). CONCLUSION: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MSpatients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.
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