Analysis of Urinary Symptoms and Urodynamic Findings in Multiple Sclerosis Patients by Gender and Disease Subtype

Background: Although urinary symptoms are prevalent in multiple sclerosis (MS), there is little information whether bladder function differs by gender or disease subtype. Objective: Differences in MS bladder function within subgroups were investigated by comparing female to male and relapsing remitting (RRMS) to secondary progressive (SPMS) patients. Methods: We reviewed 118 MS patients referred for urologic evaluation between 2007 and 2012 and extracted demographic, questionnaire (AUASI, M-ISI), and urodynamic data. Variables were analyzed by gender and MS subtype, and a multivariable regression model was generated to adjust for age and gender Results: The cohort consisted of83/35 female/male and 57/61RRMS/SPMS subjects. Urinary questionnaire and urodynamic findings were similar between genders, with the exception of higher maximum voiding pressures in males (p=0.003). RRMS patients reported more bothersome urinary symptoms compared to SPMS (AUASI21 vs. 15, p=0.004) and RRMS was independently associated with higher symptom scores on multivariable analysis (OR 17.1, p=0.008). There were no differences in urodynamic findings between subtypes. Conclusions: Male and female MS patients had similar urinary symptom scores and urodynamic findings, with the exception of higher voiding pressures in males. RRMS patients reported significantly more severe urinary symptoms on AUASI, compared to SPMS, despite having similar urodynamic findings.