Overactive bladder (OAB) and sexual dysfunction are common symptoms in patients with multiple sclerosis (MS) having a great impact on their quality of life. This study has the aim to assess the impact of OAB in MS patients focusing on the quality of sexual health and the quality of their marital relationship.

Data of consecutive male patients with diagnosis of MS and in a stable relationship (at least 6 months relationship) that attended our outpatients clinic between October 2021 and August 2022 were collected. Patients were clinically classified as Group A (patients with OAB) or Group B (patients without OAB) according to 3-days bladder diary (at least 1 episode/day). Variables including age, EDSS, prostate volume (PVol), presence of urinary incontinence (UI) and maximum urinary flow rate at uroflowmetry (Qmax) with post-voiding residual volume (PVR) were collected. Patients were asked to complete validated questionnaires to assess lower urinary tract symptoms (LUTS) by international consultation on incontinence questionnaire male lower urinary tract symptoms module (ICIQ-MLUTS), erectile function by International index of erectile function (IIEF-5) and quality of marital relationship (DAS). Student's t-test and χ2 were used to assess statistically significant differences between the two groups.

74 MS patients were included in the present analysis. 33 were included in Group A and 41 were included in Group B. There were no statistically significant differences between the two groups regarding age, prostate volume, QMax, UI rate and PVR (p>0.05). ED was present in 26 (78%) patients in group A and 13 (32%) in group B (p<0.001). Patients in group A had a lower EDSS scores respect to patients in group B (p<0.006). Patients in group A had worse results regarding LUTS assessed by ICIQ-MLUTS (p<0.02), erectile function assessed by IIEF-5 (p<0.001) and quality of marital relationship assessed by DAS (p<0.05).

The results of this study indicate that OAB assessments have to be regarded as a ED predictor. It is well-known that MS significantly contributes to a broad demyelination process, which disrupts the continuity of neural pathways and changes the neural function necessary for regular erection and sex. Increased detrusor excitability and other changes to the electromechanical characteristics of the detrusor smooth muscle are frequently linked to the disease of neurogenic bladder. Marital relationship was also affected by the severity of LUTS and OAB seems to have a role.

OAB in MS patients has a great impact in sexual health and marital relationship and should always be assessed and managed with the best options available to improve quality of life in these highly complex patients.

Continence 7S1 (2023) 101036
DOI: 10.1016/j.cont.2023.101036