GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne Université, AP-HP, 75020 Paris, France.
GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne Université, AP-HP, 75020 Paris, France.
Ann Phys Rehabil Med. 2021 Jul;64(4):101452. doi: 10.1016/j.rehab.2020.10.006. Epub 2020 Dec 5.
Lower urinary tract symptoms (LUTSs), especially overactive bladder, are frequent in people with multiple sclerosis (PwMS). Urinary urgency and urge urinary incontinence could lead to precipitation and thus could increase the risk of falling in these individuals.
We aimed to assess the association between severity of LUTSs and risk of falling in PwMS.
PwMS with LUTSs were recruited in a neuro-urology department. Participants were asked about the number of falls in the past 3 months and their circumstances. Severity of LUTSs was assessed by the Urinary Symptoms Profile (USP) score, and individuals were classified as with or without urinary incontinence.
This cross-sectional study included 154 patients (69% women); the mean (SD) age was 50.1 (11.5) years and median EDSS was 5 (interquartile range 3-6). Overall, 20 (13%) patients reported one fall during the past 3 months, and 43 (28%) reported at least 2 falls. Only 9 (6%) patients reported a fall on the way to the toilet, 6 during a urinary urgency. No link was found between falls and urinary incontinence (P=0.71), type or severity of urinary symptoms (overactivity, voiding dysfunction or stress incontinence, P>0.05). Falls on the way to the bathroom was associated with high USP score related to overactive bladder (P=0.03) and severe nocturia (>2 nocturnal micturitions) (P<0.01). Falling at night was also associated with severe nocturia (P<0.001).
The severity of LUTSs and presence of urinary incontinence do not appear related to the risk of falling in PwMS and urinary disorders but rather to the specific risk of falling on the way to the bathroom. Severe nocturia increases the risk of falling at night. Further studies are needed to assess the impact of LUTS treatment on the risk of falling. ClinicalTrials.gov (NCT04338646).
下尿路症状（LUTS），尤其是膀胱过度活动症，在多发性硬化症患者（PwMS）中很常见。尿急和急迫性尿失禁可导致失禁的发生，从而增加这些个体跌倒的风险。
我们旨在评估 LUTS 严重程度与 PwMS 跌倒风险之间的关系。
在神经泌尿科就诊的 LUTS 患者中招募了 PwMS。询问参与者在过去 3 个月中跌倒的次数及其情况。LUTS 严重程度通过尿症状谱（USP）评分评估，个体分为有或无尿失禁。
这项横断面研究纳入了 154 名患者（69%为女性）；平均（SD）年龄为 50.1（11.5）岁，中位 EDSS 为 5（四分位距 3-6）。总体而言，20 名（13%）患者在过去 3 个月报告了一次跌倒，43 名（28%）报告了至少 2 次跌倒。只有 9 名（6%）患者报告说在去厕所的路上跌倒，6 名患者在尿急时跌倒。跌倒与尿失禁之间没有联系（P=0.71），与尿症状的类型或严重程度（过度活动、排尿功能障碍或压力性尿失禁，P>0.05）也没有联系。去浴室的路上跌倒与与膀胱过度活动相关的高 USP 评分有关（P=0.03）和严重夜尿症（>2 次夜间排尿）（P<0.01）有关。夜间跌倒也与严重夜尿症有关（P<0.001）。
LUTS 严重程度和尿失禁的存在似乎与 PwMS 跌倒风险无关，而与去浴室的特定跌倒风险有关。严重夜尿症增加夜间跌倒的风险。需要进一步研究评估 LUTS 治疗对跌倒风险的影响。ClinicalTrials.gov（NCT04338646）。
