Benjamin V Ineichen1, Marc P Schneider2, Martin Hlavica3, Niels Hagenbuch4, Michael Linnebank5, Thomas M Kessler6. 1. Brain Research Institute, University of Zürich and Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland/Department of Neurology, University Hospital Zürich, Zürich, Switzerland. 2. Brain Research Institute, University of Zürich and Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland/Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland. 3. Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. 4. Private Statistician, Spiez, Switzerland. 5. Department of Neurology, University Hospital Zürich, Zürich, Switzerland/Department of Neurology, HELIOS-Klinik Hagen-Ambrock, Hagen, Germany. 6. Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
Abstract
BACKGROUND: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. OBJECTIVE: We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. METHODS: A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). RESULTS: Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. CONCLUSION: High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.
BACKGROUND: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. OBJECTIVE: We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. METHODS: A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). RESULTS: Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. CONCLUSION: High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.
Authors: Burkhard Domurath; Peter Flachenecker; Thomas Henze; Wolfgang Feneberg; Anna Brandt; Ines Kurze; Ruth Kirschner-Hermanns; Albert Kaufmann; Jörn Bremer; Manuela Vonthien; Kerstin Ratering; Christoph Schäfer; Will Nelson Vance; Paul Schmidt Journal: Nervenarzt Date: 2021-01-05 Impact factor: 1.214
Authors: Janina Beck; Anke Kirsten Jaekel; Federico Leopoldo Zeller; Michael Kowollik; Ines Kurze; Albert Kaufmann; Wolfgang Feneberg; Anna Brandt; Peter Flachenecker; Thomas Henze; Burkhard Domurath; Paul Schmidt; Will Nelson Vance; Franziska Goldschmidt; Ruth Klara Maria Kirschner-Hermanns; Stephanie C Knüpfer Journal: Diagnostics (Basel) Date: 2022-01-13