Multiple sclerosis (MS) involves focal neural demyelmation with relative sparing of axons and resultant impaired nerve conduction. Demyelination commonly affects the posterolateral columns of the spinal cord, with the majority of patients having cervi cal cord involvement. Forty percent of patients have lumbar cord involvement and 18 percent have sacral cord involvement. The cerebral cortex and midbram may also be affected. Lesions in any of these areas can affect voiding function.
References
1.
Bakke A., Myhr KM, Gronning M., Nyland H.Bladder, bowel and sexual dysfunction in patients with multiple sclerons—a cohort studyScand J Urol Nephrol Suppl1996 , 179:61-66
2.
Dula E., Leach GERole of the urologist in diagnosis of multiple sclerosisUrology1991, 37:21
3.
Sirls LT, Zimmern PE, Leach GERole of limited evaluation and aggressive medical management in multiple sclerosis: A review of 113 patientsJ Urol1994, 151:946-950
4.
Blaivas JG, Barbalias GADetrusor-external sphincter dyssynergia in men with multiple sclerosis an ominous urologic conditionJ Urol1984 ; 13191
5.
McGuire EJ, Savastino JAUrodynamic findings and long-term outcome management of patients with multiple sclerosis-induced lower urinary tract dysfunctionJ Urol1984; 132.713.
6.
Staskin DRHydroureteronephrosis after spinal cord injuryUrol Clin North Am1991. 18(2).309-325.
7.
Resnick NM, Yalla SV, Laurino E.The pathophysiology of urinary incontinence among institutionalized elderly personsNew Engl J Med1989; 320(1):1-7.
8.
Goldstein I. , Siroky MB, Saz DS, Krane RJNeurologic abnormalities in multiple sclerosisJ Urol1982; 128.541.
9.
Blaivas JG, Zayed AA, Labib KBThe bulbocavemosus reflex in urology: A prospective study of 299 patientsJ Urol1981, 126(2).197-199.
10.
Guttierez PA , Young RR, Vulpe M.Spinal cord injury. An overviewUrol Clin North Am1993, 20(3):373-401
11.
Sirls LT, Choe JMThe incontinence history and physical examination In O'Donnell P (ed.). Urinary incontinenceSt. LouisMosby, 1997, Ch. 8, p 54.
12.
Mayo ME, Chetner MPLower urinary tract dysfunction in multiple sclerosisUrology1992; 39:67.
13.
Gonor SE, Carroll DJ, Metcalfe JBVesical dysfunction in multiple sclerosisUrology1985, 25.429
14.
Ouslander JG , Leach GE, Staskm DRSimplified tests of lower urinary tract function in the evaluation of geriatric urinary incontinenceJ Am Genatr Soc1989; 37(8) 706-714
15.
Holevas RE, Hadley R.Voiding dysfunction with nontraumatic neurologic disease AUA Update Series, Volume IX, Lesson 38, 1992
16.
Kennelly MJ, Rudy DCIncontinence caused by neurologic disease In. O'Donnell P (ed ) Urinary IncontinenceSt. Louis.Mosby, 1997, Ch 47, p. 338
17.
Weese D., Roskamp D., Leach GE, Zimmern PEIntravesical oxybutinin chloride Experience with 42 patientsUrology1993, 41(6) 527.
18.
Abrams P., Freeman R., Anderstrom C., Mattiasson A.Tolterodine, a new antimuscarinic agent. As effective but better tolerated than oxybutynin in patients with an overactive bladderBr J Urol199881(6):801-810
19.
Gillberg PG , Sudnquist S.Comparison of the in vitro and in vivo profiles of tolterodine with those of subtype-selective muscarinic reecptor antagonistsEur J Pharm1998; 349(2-3).285-292.
20.
Hills CJ, Winter SA, Balfour JATolterodineDrugs1998; 55(6):813-820.
21.
Wein AJEvaluation of treatment response in benign prostatic hyperplasiaAUA Update Series, Volume X, Lesson 9, 1991.
22.
Andrews KL, Husmann DABladder dysfunction and management in multiple sclerosisMayo Clin Proc1997; 72(12):1176-1183.
