Journal article
High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.
- Ineichen BV 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.
- Schneider MP 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.
- Hlavica M Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Hagenbuch N Private Statistician, Spiez, Switzerland.
- Linnebank M Department of Neurology, University Hospital Zürich, Zürich, Switzerland/Department of Neurology, HELIOS-Klinik Hagen-Ambrock, Hagen, Germany.
- Kessler TM Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
- 2017-04-04
Published in:
- Multiple sclerosis (Houndmills, Basingstoke, England). - 2018
Expanded Disability Status Scale (EDSS)
Multiple sclerosis (MS)
detrusor sphincter dyssynergia (DSD)
neuro-urology
neurogenic lower urinary tract dysfunction (NLUTD)
overactive bladder
prospective study
vesico-uretero-renal reflux
Adult
Aged
Female
Humans
Male
Middle Aged
Multiple Sclerosis
Risk Factors
Treatment Outcome
Urinary Bladder, Neurogenic
Urinary Tract
Urodynamics
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1177/1352458517703801
- PMID 28367674
- Persistent URL
- https://sonar.ch/global/documents/144729
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