[多发性硬化症患者的膀胱、肠道及性功能障碍]

Burina Adnan, Sinanović Osman

Medicinski Fakultet Univerziteta U Tuzli.

Med Arh. 2006;60(3):182-4.

Bladder, bowel and sexual dysfunction are not rare in multiple sclerosis (MS). The most frequent bladder disorders are in urgency, frequency as well as retention. In this study we analyzed bladder dysfunction (urgency, frequency and retention), defecation (constipation and incontinence) as well as sexual problems (libido, erection and vaginal lubrication) in patients with relapsing-remitting form of multiple sclerosis (MS) depending on disability status. Concerning Expanded Diasability Status Score (EDSS), patients have been divided in two groups: EDSS 0-4.5. (Group A), and EDSS 5.0-10.0 (group B). We analyzed 60 patients: 35 (58.3%) women, and 25 (41.7%) men. In both group A and B, with no bladder disorder was 18 patients (30%). In group A: 15 (25%); in group B: 3 (5%). With urgent incontinence were 36 (60%) patients - group A: 19 (31%); group B: 17 (28%). With retention were 6 (10%) patients - group A: 4 (6.6%); group B: 2 (3.3%). There is no statistical significant difference in number of patients with and with no urinary problems in both groups (p>0.05). Of all analyzed patients in group A and B with no urinary disorders were 9 men (15%) and 9 women (15%). With urinary problems were 16 men (26.7%) and 26 women (43.3%). Statistically it is significant higher number of women than men (p<0.05). With no defecation problems were 54 (90%) patients - in group A: 36 (60%); in group B: 18 (30%). With constipation were 5 (8.3%) - in group A: 2 (3.3%); in group B 3 (5%). In group B one patient (1.6%) had incontinence. There is no statistical significant difference in number of patients with and with no bowel elimination dysfunction in both groups p>0.05). 12 (20%) men had no bowel elimination problems and 24 women (40%), but 10 (16.6%) men and 8 (13.3%) women had the bowel elimination dysfunction. There is no statistical significance (p>0.05). No libido disturbance had 44 (73.3%) patients. In the group A: 35 (58.3%); in group B: 9 (15%). 16 (26.7%) patients had the libido disturbances. In group A: 3 (5%); in group B 13 (21.6%). Statistically there is significant lower number of patients with libido problems in group A (p<0.05). No vaginal lubrication had 21 (35%) women. In group A: 18 (30%); in group B 3 (5%). Vaginal lubrication disturbance had 14 (23.3%). In group A: 7 (11.6%); in group B 7 (11.6%). Statistically it is significant lower number of women with no lubrication in group B (p<0.05). No erection problems had 11 (18.3%) men. In group A: 9 (15%); in group B 2 (3.3%). Erection disturbance had 14 (23.3%). In group A: 4 (6.6%); in group B: 10 (16.6%). There is statistical significant lower number of men with erection problems in group A. (p<0.05). Of all analyzed patients in both groups A and B 18 men (30%) and 26 (43%) women had no problems with libido and 7 (11.6%) men and 9 (15%) women had the problems. There is no statistical significance in sex distribution (p>0.05). 11 (18.3%) men had no erection problems, 14 (23.3%) had the problems. 21 (35%) women had no vaginal lubrication problems, 14 (23.3%) women had the problems. Erection disturbances are not statistically significant to vaginal lubrication problems (p>0.05).

膀胱、肠道及性功能障碍在多发性硬化症（MS）中并不罕见。最常见的膀胱疾病是尿急、尿频以及尿潴留。在本研究中，我们根据残疾状况分析了复发缓解型多发性硬化症（MS）患者的膀胱功能障碍（尿急、尿频和尿潴留）、排便情况（便秘和大便失禁）以及性问题（性欲、勃起和阴道润滑）。关于扩展残疾状态评分（EDSS），患者被分为两组：EDSS 0 - 4.5（A组）和EDSS 5.0 - 10.0（B组）。我们分析了60例患者：35例（58.3%）女性和25例（41.7%）男性。A组和B组中，无膀胱疾病的患者均为18例（30%）。A组：15例（25%）；B组：3例（5%）。有急迫性尿失禁的患者有36例（60%）——A组：19例（31%）；B组：17例（28%）。有尿潴留的患者有6例（10%）——A组：4例（6.6%）；B组：2例（3.3%）。两组中有无泌尿系统问题的患者数量无统计学显著差异（p>0.05）。在A组和B组所有分析的患者中，无泌尿系统疾病的男性有9例（15%），女性有9例（15%）。有泌尿系统问题的男性有16例（26.7%），女性有26例（43.3%）。从统计学上看，女性的数量显著高于男性（p<0.05）。无排便问题的患者有54例（90%）——A组：36例（60%）；B组：18例（30%）。有便秘的患者有5例（8.3%）——A组：2例（3.3%）；B组3例（5%）。B组有1例患者（1.6%）有大便失禁。两组中有无肠道排泄功能障碍的患者数量无统计学显著差异（p>0.05）。12例（20%）男性无肠道排泄问题，24例女性（40%）无肠道排泄问题，但10例（16.6%）男性和8例（13.3%）女性有肠道排泄功能障碍。无统计学意义（p>0.05）。44例（73.3%）患者无性欲障碍。A组：35例（58.3%）；B组：9例（15%）。16例（26.7%）患者有性欲障碍。A组：3例（5%）；B组13例（21.6%）。从统计学上看，A组有性欲问题的患者数量显著更低（p<0.05）。21例（35%）女性无阴道润滑。A组：18例（30%）；B组3例（5%）。有阴道润滑障碍的患者有14例（23.3%）。A组：7例（11.6%）；B组7例（11.6%）。从统计学上看，B组无润滑的女性数量显著更低（p<0.05）。11例（18.3%）男性无勃起问题。A组：9例（15%）；B组2例（3.3%）。有勃起障碍的患者有14例（23.3%）。A组：4例（6.6%）；B组：10例（16.6%）。A组有勃起问题的男性数量在统计学上显著更低（p<0.05）。在A组和B组所有分析的患者中，18例男性（30%）和26例（43%）女性无性欲问题，7例（11.6%）男性和9例（15%）女性有性欲问题。性别分布无统计学意义（p>0.05）。11例（18.3%）男性无勃起问题，14例（23.3%）有勃起问题。21例（35%）女性无阴道润滑问题，14例（23.3%）女性有阴道润滑问题。勃起障碍与阴道润滑问题无统计学显著差异（p>0.05）。