Association Between the Neurogenic Bladder Symptom Score and Urodynamic Examination in Multiple Sclerosis Patients With Lower Urinary Tract Dysfunction
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Purpose: To determine the relationship between the neurogenic bladder symptoms score (NBSS) and urodynamic examination in patients affected by multiple sclerosis (MS) and related lower urinary tract dysfunction (LUTD). Methods: We recruited 122 consecutive patients with MS in remission and LUTD from January 2011 to September 2013 who underwent their first urodynamic examination. Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS) and bladder symptoms were studied with the NBSS. Results: Median NBSS was 20.0 (interquartile range, 12.75–31.0). Neurogenic detrusor overactivity (NDO) was discovered in 69 patients (56.6%). The concordance between patients with NDO and maximum detrusor pressure during involuntary detrusor contraction (PdetmaxIDC)≥20.0 cm H2O was 0.89 (κ-Cohen; P<0.05). Patients with EDSS scores of ≥4.5 had a greater NBSS (25.41 vs. 20.19, P<0.05), NBSS-incontinence (8.73 vs. 4.71, P<0.05), NBSS-consequence (4.51 vs. 3.13, P<0.05) and NBSS-quality of life (2.14 vs. 1.65, P<0.05). The NBSS was not associated with PdetmaxIDC≥20 cm H2O (P=0.77) but with maximum cystometric capacity<212 mL (odds ratio, 0.95; P<0.05). Conclusions: The NBSS cannot give adequate information the way urodynamic studies can, in patients with MS and LUTD.
Abstract
Purpose: To determine the relationship between the neurogenic bladder symptoms score (NBSS) and urodynamic examination in patients affected by multiple sclerosis (MS) and related lower urinary tract dysfunction (LUTD). Methods: We recruited 122 consecutive patients with MS in remission and LUTD from January 2011 to September 2013 who underwent their first urodynamic examination. Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS) and bladder symptoms were studied with the NBSS. Results: Median NBSS was 20.0 (interquartile range, 12.75–31.0). Neurogenic detrusor overactivity (NDO) was discovered in 69 patients (56.6%). The concordance between patients with NDO and maximum detrusor pressure during involuntary detrusor contraction (PdetmaxIDC)≥20.0 cm H2O was 0.89 (κ-Cohen; P<0.05). Patients with EDSS scores of ≥4.5 had a greater NBSS (25.41 vs. 20.19, P<0.05), NBSS-incontinence (8.73 vs. 4.71, P<0.05), NBSS-consequence (4.51 vs. 3.13, P<0.05) and NBSS-quality of life (2.14 vs. 1.65, P<0.05). The NBSS was not associated with PdetmaxIDC≥20 cm H2O (P=0.77) but with maximum cystometric capacity<212 mL (odds ratio, 0.95; P<0.05). Conclusions: The NBSS cannot give adequate information the way urodynamic studies can, in patients with MS and LUTD.
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