A Comparison of the Lower Urinary System Symptoms of Women with Multiple Sclerosis and Healthy Subjects

Yıl 2021, Cilt: 26 Sayı: 2, 143 - 154, 29.05.2021

Gözde Tekin Nuriye Özengin , Sule Aydın Türkoğlu , Handan Ankaralı , Yeşim Bakar

https://doi.org/10.21673/anadoluklin.781617

Cited By: 2

Öz

Aim: In this study, we aimed to compare the lower urinary tract symptoms of women diagnosed with multiple sclerosis (MS) and healthy volunteers.

Methods: The study included 48 women with MS (mean age: 41.13±10.93 years) and 51 healthy women (38.88±10.26 years). Sociodemographic characteristics were recorded. Then, lower urinary tract symptoms, pelvic floor problems, overactive bladder symptoms, and quality of life were assessed by the Bristol Female Lower Urinary Tract Symptom Index (BFLUTSI), the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Global Pelvic Floor Bother Questionnaire (GPFBQ), the Overactive Bladder Questionnaire-V8 (OAB-V8), and the Multiple Sclerosis Quality of Life Ques-tionnaire-54 (MSQOL-54), respectively.

Results: A significant difference was found between the two groups in terms of their BFLUTSI storage, incontinence, and quality of life subscale and total scores (p≤0.05). Compared to healthy women, urinary incontinence complaints, mixed urinary incontinence frequency, pelvic floor problems, and overactive bladder symptoms were more common in women with MS (p≤0.05). The mean MSQOL-54 physical and mental health composite scores of women with MS were 58.65±19.08 and 63.68±20.48, respectively; and their mean MSQOL-54 total health score was found to be 122.33±36.2.

Conclusion: In women with MS, lower urinary tract symptoms are more common and quality of life is negatively affected. In clinical evaluations, urinary incontinence problems should not be neglected and symptoms of the lower urinary tract should also be examined.

Anahtar Kelimeler

Demyelinating diseases, urinary incontinence, pelvic floor, multipl sclerosis, urinary symptoms, woman

Multipl Skleroz Tanılı ve Sağlıklı Kadınların Alt Üriner Sistem Semptomlarının Karşılaştırılması

Öz

Amaç: Bu çalışmada, multipl skleroz (MS) tanılı kadınların ve sağlıklı gönüllülerin alt üriner sistem semptomlarını karşılaştırmak amaçlanmıştır.

Yöntem: Çalışmaya MS’li 48 kadın (ortalama yaş 41,13±10,93 yıl) ile sağlıklı 51 kadın (38,88±10,26 yıl) dahil edildi. Sosyodemografik özellikler kaydedildikten sonra alt üriner sistem semptomları Bristol Kadın Alt Üriner Sistem Semptomları İndeksi (BKAÜSSİ) ile, pelvik taban prob¬lemleri Pelvik Taban Distres Envanteri-20 (PTDE-20) ve Global Pelvik Taban Rahatsızlık Anketi (GPTRA) ile, aşırı aktif mesane semptomları Aşırı Aktif Mesane Anketi-V8 (AAM-V8) ile, yaşam kali¬tesi Multipl Skleroz Yaşam Kalitesi Anketi-54 (MSYKA-54) ile değerlendirildi.

Bulgular: İki grubun BKAÜSSİ depolama, inkontinans ve yaşam kalitesi alt boyut ve toplam puan¬ları arasında anlamlı fark saptandı (p≤0,05). Üriner inkontinans şikayetleri, mikst üriner inkontinans sıklığı, pelvik taban problemleri ve aşırı aktif mesane semptomları MS’li kadınlarda sağlıklı kadınlara kıyasla daha yaygındı (p≤0,05). MS’li kadınların ortalama MSYKA-54 bileşik fiziksel ve mental sağ¬lık puanları sırasıyla 58,65±19,08 ve 63,68±20,48 idi, ortalama MSYKA-54 total sağlık puanları ise 122,33±36,2 olarak tespit edildi.

Sonuç: MS’li kadınlarda alt üriner sistem semptomları daha yaygındır ve yaşam kalitesi olumsuz etkilenmektedir. Klinik değerlendirmelerde üriner inkontinans problemleri göz ardı edilme¬meli, alt üriner sistem semptomları da incelenmelidir

Anahtar Kelimeler

Demiyelinizan hastalıklar, üriner inkontinans, pelvik taban, kadın, multipl skleroz, üriner semptomlar

Kaynakça

• Börü ÜT, Duman A, Kulualp AŞ, Güler N, Taşdemir M, Yılmaz Ü, ve ark. Multiple sclerosis prevalence study: the comparison of 3 coastal cities, located in the black sea and Mediterranean regions of Turkey. Medicine. 2018;97(42):e12856.
• Gold R, Wolinsky J. Pathophysiology of multiple sclero¬sis and the place of teriflunomide. Acta Neurol Scand. 2011;124(2):75–84.
• Etoom M, Khraiwesh Y, Lena F, Hawamdeh M, Hawam¬deh Z, Centonze D, ve ark. Effectiveness of physiotherapy interventions on spasticity in people with multiple sclerosis: a systematic review and meta-analysis. Am J Phys Med Rehabil. 2018;97(11):793–807.
• Amato MP, Derfuss T, Hemmer B, Liblau R, Montalban X, Soelberg Sørensen P, ve ark. Environmental modi¬fiable risk factors for multiple sclerosis: report from the 2016 ECTRIMS focused workshop. Mult Scler. 2018;24(5):590–603.
• Brownlee WJ, Hardy TA, Fazekas F, Miller DH. Diagno¬sis of multiple sclerosis: progress and challenges. Lancet. 2017;389(10076):1336–46.
• Fong A, Chau CT, Quant C, Duffy J, Pan D, Ogunyemi DA. Multiple sclerosis in pregnancy: prevalence, socio-demographic features, and obstetrical outcomes. J Ma¬tern Fetal Neonatal Med. 2018;31(3):382–7.
• Gilmour H, Ramage-Morin PL, Wong SL. Multiple scle¬rosis: prevalence and impact. Health Rep. 2018;29(1):3–8.
• Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Be¬hav. 2015;5(9):e00362.
• Lassmann H, Brück W, Lucchinetti CF. The immunopat¬hology of multiple sclerosis: an overview. Brain Pathol. 2007;17(2):210–8.
• Aharony SM, Lam O, Corcos J. Evaluation of lower uri¬nary tract symptoms in multiple sclerosis patients: re¬view of the literature and current guidelines. Can Urol Assoc J. 2017;11(1–2):61.
• Litwiller SE, Frohman EM, Zimmern PE. Multiple scle¬rosis and the urologist. J Urol. 1999;161(3):743–57.
• Brucker BM, Nitti VW, Kalra S, Herbert J, Sadiq A, Utomo P, ve ark. Barriers experienced by patients with multiple sclerosis in seeking care for lower urinary tract symptoms. Neurourol Urodyn. 2017;36(4):1208–13.
• Khalaf KM, Coyne KS, Globe DR, Armstrong EP, Malo¬ne DC, Burks J. Lower urinary tract symptom prevalence and management among patients with multiple sclero¬sis. Int J MS Care. 2015;17(1):14–25.
• Collins CD, Ivry B, Bowen JD, Cheng EM, Dobson R, Goodin DS, ve ark. A comparative analysis of patient-re¬ported expanded disability status scale tools. Mult Scler. 2016;22(10):1349–58.
• Meyer-Moock S, Feng YS, Maeurer M, Dippel FW, Kohlmann T. Systematic literature review and vali¬dity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurol. 2014;14(1):58.
• Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, ve ark. Mobility, balance and falls in persons with multiple sclerosis. PloS One. 2011;6(11):e28021.
• Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Ne¬urology. 1983;33(11):1444–52.
• Jackson S, Donovan J, Brookes S, Eckford S, Swithin¬bank L, Abrams P. The Bristol female lower urinary tract symptoms questionnaire: development and psychomet¬ric testing. Br J Urol. 1996;77(6):805–12.
• Gökkaya C, Öztekin Ç, Doluoğlu Ö, Güzel O, Erşahin V, Özden C, ve ark. Validation of Turkish version of Bris¬tol Female Lower Urinary Tract Symptom Index. J Clin Anal Med. 2012;3(4):415–8.
• Barber M, Walters M, Bump R. Short forms of two con¬dition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13.
• Celenay ST, Akbayrak T, Kaya S, Ekici G, Beksac S. Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20. Int Urogynecol J. 2012;23(8):1123–7.
• Peterson TV, Karp DR, Aguilar VC, Davila GW. Valida¬tion of a global pelvic floor symptom bother questionna¬ire. Int Urogynecol J. 2010;21(9):1129–35.
• Doğan H, Özengin N, Bakar Y, Duran B. Reliability and validity of a Turkish version of the Global Pel¬vic Floor Bother Questionnaire. Int Urogynecol J. 2016;27(10):1577–81.
• Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bent¬kover J, ve ark. Psychometric validation of an overactive bladder symptom and health-related quality of life ques¬tionnaire: the OAB-q. Qual Life Res. 2002;11(6):563–74.
• Acquadro C, Kopp Z, Coyne KS, Corcos J, Tubaro A, Choo MS. Translating overactive bladder questionnaires in 14 languages. Urology. 2006;67(3):536–40.
• Tarcan T, Mangır N, Özgür MÖ, Akbal C. OAB-V8 Aşı¬rı aktif mesane sorgulama formu validasyon çalışması. Üroloji Bült. 2012;21(21):113–6.
• Idiman E, Uzunel F, Ozakbas S, Yozbatiran N, Oguz M, Callioglu B, ve ark. Cross-cultural adaptation and vali¬dation of multiple sclerosis quality of life questionnaire (MSQOL-54) in a Turkish multiple sclerosis sample. J Neurol Sci. 2006;240(1):77–80.
• Vickrey B, Hays RD, Harooni R, Myers LW, Ellison GW. A health-related quality of life measure for multiple scle¬rosis. Qual Life Res. 1995;4(3):187–206.
• Haylen BT, de Ridder D, Freeman RM, Swift SE, Berg¬hmans B, Lee J, ve ark. An International Urogyneco¬logical Association (IUGA)/International Continen¬ce Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
• Minassian VA, Bazi T, Stewart WF. Clinical epidemiolo¬gical insights into urinary incontinence. Int Urogynecol J. 2017;28(5):687–96.
• Koch T, Kralik D, Eastwood S, Schofield A. Breaking the silence: women living with multiple sclerosis and uri¬nary incontinence. Int J of Nurs Pract. 2001;7(1):16–23.
• Murphy AM, Bethoux F, Stough D, Goldman HB. Pre¬valence of stress urinary incontinence in women with multiple sclerosis. Int Neurourol J. 2012;16(2):86.
• Dillon BE, Seideman CA, Lee D, Greenberg B, Froh¬man EM, Lemack GE. A surprisingly low prevalence of demonstrable stress urinary incontinence and pel¬vic organ prolapse in women with multiple sclerosis followed at a tertiary neurogenic bladder clinic. J Urol. 2013;189(3):976–9.
• Panicker JN, de Sèze M, Fowler CJ. Rehabilitation in practice: neurogenic lower urinary tract dysfunction and its management. Clin Rehabil. 2010;24(7):579–89.
• Nortvedt M, Riise T, Myhr K, Landtblom AM, Bakke A, Nyland H. Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction. Mult Scler. 2001;7(4):231–5.
• Borello-France D, Leng W, O’Leary M, Xavier M, Erick¬son J, Chancellor MB, ve ark. Bladder and sexual func¬tion among women with multiple sclerosis. Mult Scler. 2004;10(4):455–61.
• Jameson J, Rogers J, Chia Y, Misiewicz J, Henry M, Swash M. Pelvic floor function in multiple sclerosis. Gut. 1994;35(3):388–90.
• Vahtera T, Haaranen M, Viramo-Koskela A, Ruutiainen J. Pelvic floor rehabilitation is effective in patients with multiple sclerosis. Clin Rehabil. 1997;11(3):211–9.
• White LJ, Dressendorfer RH. Exercise and multiple scle¬rosis. Sports Med. 2004;34(15):1077–100.
• Lúcio AC, Campos RM, Perissinotto MC, Miyaoka R, Damasceno BP, D’ancona CAL. Pelvic floor muscle trai¬ning in the treatment of lower urinary tract dysfunction in women with multiple sclerosis. Neurourol Urodyn. 2010;29(8):1410–3.
• Quarto G, Autorino R, Gallo A, de Sio M, D’Armiento M, Perdonà S, ve ark. Quality of life in women with multiple sclerosis and overactive bladder syndrome. Int Urogynecol J. 2007;18(2):189–94.
• Ysrraelit MC, Fiol MP, Gaitán MI, Correale J. Quality of life assessment in multiple sclerosis: different percep¬tion between patients and neurologists. Front Neurol. 2018;8:729.
• Mitchell AJ, Benito-León J, González J-MM, Rivera- Navarro J. Quality of life and its assessment in multiple sclerosis: integrating physical and psychological compo¬nents of wellbeing. Lancet Neurol. 2005;4(9):556–66.
• Tabrizi FM, Radfar M. Fatigue, sleep quality, and disabi¬lity in relation to quality of life in multiple sclerosis. Int J MS Care. 2015;17(6):268–74.
• Rezapour A, Kia AA, Goodarzi S, Hasoumi M, Motlagh SN, Vahedi S. The impact of disease characteristics on multiple sclerosis patients’ quality of life. Epidemiol He¬alth. 2017;39:e2017008.
• Mikula P, Nagyova I, Krokavcova M, Vitkova M, Ro¬senberger J, Szilasiova J, ve ark. Social participation and health-related quality of life in people with multiple scle¬rosis. Disabil Health J. 2015;8(1):29–34.