Krhut Jan, Hradílek Pavel, Kondé Adéla, Skugarevská Barbora, Woznicová Ivana, Sýkora Radek Paus, Kobberø Hanne, Rychlý Tomáš, Zvara Peter
Department of Urology, University Hospital, Tř. 17. listopadu 1790, Ostrava, 708 52, Czech Republic.
Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic.
World J Urol. 2025 May 31;43(1):342. doi: 10.1007/s00345-025-05709-y.
To estimate the timepoint of onset of the lower urinary tract symptoms (LUTS) over the course of multiple sclerosis (MS), determine which of the LUTS typically appears first, and identify risk factors for early development of LUTS in patients with MS (PwMS).
This observational study included 1167 PwMS. The participants were predominantly women (72%), median age was 45 (IQR 36;53) years, and median disease duration was 11 (IQR 6;16) years. Inclusion criteria were age over 18 years, proven MS diagnosis according to McDonald´s criteria (2017), and complete medical records since establishment of MS diagnosis. A structured in-person interview addressing the study objectives was performed during routine follow-up visit. The data were cross-checked with the medical records.
Median LUTS-free survival time after MS diagnosis has been made, was 8 (IQR 7;10) years. Storage, voiding and postmicturition symptoms were identified as a first LUTS in 549/709 (77%), 130/709 (18%), and 30/709 (4.2%) PwMS, respectively. Most frequently reported first LUTS was urgency 360 (51%). Using multivariate analysis, higher age, higher degree of disability, and presence of cerebellar and/or pyramidal symptoms at the time of MS diagnosis were significantly associated with shorter LUTS-free survival. No significant relationship between LUTS-free survival and sex or type of MS was found.
Our data show, that LUTS occur after median time of 8 years after MS diagnosis, with urgency being the most frequently reported first LUTS.
评估多发性硬化症(MS)病程中下尿路症状(LUTS)的发病时间点,确定哪种LUTS通常最先出现,并识别MS患者(PwMS)中LUTS早期发生的危险因素。
这项观察性研究纳入了1167例PwMS。参与者以女性为主(72%),中位年龄为45岁(四分位间距36;53岁),中位病程为11年(四分位间距6;16年)。纳入标准为年龄超过18岁,根据2017年麦克唐纳标准确诊为MS,且自确诊MS以来有完整的医疗记录。在常规随访期间进行了一次针对研究目标的结构化面对面访谈。数据与医疗记录进行了交叉核对。
确诊MS后的中位无LUTS生存时间为8年(四分位间距7;10年)。储尿、排尿和排尿后症状分别在549/709例(77%)、130/709例(18%)和30/709例(4.2%)的PwMS中被确定为首发LUTS。最常报告的首发LUTS是尿急,共360例(51%)。多因素分析显示,年龄较大、残疾程度较高以及MS诊断时存在小脑和/或锥体束症状与无LUTS生存时间较短显著相关。未发现无LUTS生存时间与性别或MS类型之间存在显著关系。
我们的数据表明,LUTS在MS诊断后的中位时间8年后出现,尿急是最常报告的首发LUTS。