Lower urinary tract symptoms (LUTS) are a major clinical problem and a significant cause of disability in multiple sclerosis (MS) patients. MS is a chronic disease that affects relatively young people which makes LUTS have an adverse effect on the quality of life of patients for many years. There are no studies that investigate the adaptation of MS patients towards these LUTS. The aim of this study is to evaluate for the first time the evolution of LUTS in reference to the duration of MS disease and the adaptation that might happen with time.

40 patients with MS and LUTS were recruited between July and November 2017. Patients who have other causes for their urinary symptoms such as benign prostatic hypertrophy, prostate cancer, bladder cancer, urethral stenosis or a history of urological surgeries were excluded from the study. Information including the patients age, duration of MS, voiding and filling LUTS, UBQMS (1) (Urinary Bothersome Questionnaire in multiple sclerosis), OABSS (Overactive Bladder Symptom Score), IPSS-V (Voiding sub-score of the International Prostate Symptom Score including straining, intermittency, slow stream and feeling of incomplete emptying) and urologic quality of life (SF-QUALIVEEN) (2) was gathered through questionnaires during personal interviews. Correlation was studied using bivariate correlation test to measure the linear relation between variables.

40 Patients were equally divided between genders, with an age of 43 ± 10 years, a mean MS duration of 11.6 ± 8 years, a mean UBQMS-filling score of 1.98 ± 1 , a mean UBQMS-voiding score of 1.55 ± 1.1 and a mean SF-QUALIVEEN score of 1.66 ± 0.8 .
We found a significant negative correlation between the age of the patients and the UBQMS-filling score (p<0.01) but not with the UBQMS-voiding score (p=0.7), nor the OABSS (p=0.5) or the IPSS-Voiding (p=0.7). This negative correlation was also found between the age of the patients and SF-QUALIVEEN (p=0.049).
The same correlation was found between the duration of MS and UBQMS-filling (p=0.03), UBQMS-voiding (p=0.7), OABSS (p=0.49), IPSS-Voiding (p=0.46) and SF-QUALIVEEN (p=0.046).

Pearson correlation:

Age / Duration of MS: r= 0.451, p <0.01*

Age / UBQMS-filling score: r= -0.415, p<0.01*
Age / UBQMS-voiding score: r= -0.059, p= 0.7
Age / OABSS: r= -0.100, p= 0.5
Age / IPSS-V: r= 0.077, p= 0.7
Age / SF-QUALIVEEN: r= -0.313, p= 0.049*

Duration of MS / UBQMS-filling score: r= -0.344, p= 0.03*
Duration of MS / UBQMS-voiding score: r= -0.057, p=0.7
Duration of MS / OABSS: r= -0.112, p= 0.49
Duration of MS / IPSS-V: r= 0.127, p=0.46
Duration of MS / SF-QUALIVEEN: r= -0.317, p= 0.046*

Even though age and longer duration of MS were not correlated with the severity of LUTS or with UBQMS-voiding score, there was a significant negative correlation with UBQMS-filling score and urologic quality of life, which translates into an adaptation with time towards filling LUTS.

This is the first time that an adaptation mechanism is demonstrated in MS patients with LUTS that makes them less affected by the severity of their filling LUTS with time.

Amarenco G, Chartier-Kastler E, Denys P, Jean JL, de Sèze M, Lubetzski C. First-line urological evaluation in multiple sclerosis: validation of a specific  decision-making algorithm. Mult Scler. 2013 Dec;19(14):1931-7. doi: 10.1177/1352458513489758. Epub 2013 May 22. PubMed PMID: 23698129.
Bonniaud V, Bryant D, Parratte B, Guyatt G. Development and validation of the short form of a urinary quality of life questionnaire: SF-Qualiveen. J Urol. 2008 Dec;180(6):2592-8. Epub 2008 Oct 31