Vitkova Marianna, Rosenberger Jaroslav, Krokavcova Martina, Szilasiova Jarmila, Gdovinova Zuzana, Groothoff Johan W, van Dijk Jitse P
Department of Neurology, Faculty of Medicine .
Disabil Rehabil. 2014;36(12):987-92. doi: 10.3109/09638288.2013.825332. Epub 2013 Aug 20.
Bladder, bowel and sexual dysfunction are often overlooked symptoms in patients with multiple sclerosis (MS) and can be associated with lower health-related quality of life (HRQoL). The aim is to explore the association of bladder, bowel and sexual dysfunction with HRQoL in MS patients stratified by disease duration (≤5 and >5 years) and controlled for clinical and sociodemographic variables.
The study comprised 223 MS patients (mean age 38.9 ± 10.8 years, 67% female, mean EDSS 3.0 ± 1.5) who filled out the Short-Form-36 Health Survey, the Bladder Control Scale, the Bowel Control Scale and the Incapacity Status Scale. The relationships between the variables were analyzed with multiple linear regression using the SF36's Physical Component Summary (PCS) and Mental Component Summary (MCS) as dependent variables.
More severe bladder dysfunction was associated with lower PCS in both disease duration groups (β = -0.35, p ≤ 0.001 versus β = -0.43, p ≤ 0.001), whereas more severe sexual dysfunction was associated with lower MCS in the group with shorter disease duration (β = -0.23, p ≤ 0.05).
Bladder and sexual dysfunction are associated with a poorer HRQoL in MS patients even if they have had MS for a relatively short time. Recognition and proper treatment is needed to prevent the development of more severe dysfunction; this may also lead to a better HRQoL.
Bladder and sexual dysfunction are associated with a poor health-related quality of life in MS patients. Sexual dysfunction may explain mental health issues among individuals with a short disease duration. Recognition and treatment may prevent the development of more severe sexual and bladder dysfunction and increase physical health-related quality of life.
膀胱、肠道及性功能障碍在多发性硬化症（MS）患者中常被忽视，且可能与较低的健康相关生活质量（HRQoL）相关。本研究旨在探讨按病程（≤5年和>5年）分层并控制临床及社会人口学变量的MS患者中，膀胱、肠道及性功能障碍与HRQoL之间的关联。
本研究纳入223例MS患者（平均年龄38.9±10.8岁，67%为女性，平均扩展残疾状态量表[EDSS]评分为3.0±1.5），这些患者填写了简明健康状况调查问卷（Short-Form-36 Health Survey）、膀胱控制量表、肠道控制量表及失能状态量表。以SF36的身体成分总结（PCS）和心理成分总结（MCS）作为因变量，采用多元线性回归分析变量之间的关系。
在两个病程组中，更严重的膀胱功能障碍均与较低的PCS相关（β=-0.35，p≤0.001对比β=-0.43，p≤0.001），而在病程较短的组中，更严重的性功能障碍与较低的MCS相关（β=-0.23，p≤0.05）。
即使MS患者患病时间相对较短，膀胱及性功能障碍也与较差的HRQoL相关。需要识别并进行适当治疗以预防更严重功能障碍的发展；这也可能带来更好的HRQoL。
膀胱及性功能障碍与MS患者较差的健康相关生活质量相关。性功能障碍可能解释病程较短个体中的心理健康问题。识别和治疗可能预防更严重的性功能和膀胱功能障碍的发展，并提高与身体健康相关的生活质量。
