The association between spasticity and urinary incontinence and impact on quality of life in patients with multiple sclerosis

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Brigita Afanasjeva1, Dominykas Afanasjevas 2, Povilas Beliaziūnas 3, Raminta Macaitytė 4 , Renata Balnytė 5, *

1 Medical Academy, Lithuanian University of Health Sciences;

2 Medical Academy, Lithuanian University of Health Sciences;

3 Department of Neurology, Medical Academy, Lithuanian University of Health Sciences;

4 Department of Neurology, Medical Academy, Lithuanian University of Health Sciences;

5 Department of Neurology, Medical Academy, Lithuanian University of Health Sciences;

Abstract: Background and objectives: Based on the literature, up to 80% of multiple sclerosis patients develop spasticity, urinary problems occur up to 90%. Spasticity and bladder dysfunction most likely represent different manifestations of the same underlying pathology, i.e. damage to the descending tracts in the spinal cord. The aim of the study was to evaluate the links between the spasticity and bladder dysfunction and quality of life in patients with multiple sclerosis. Materials and Methods: a cross-sectional study was performed at Lithuanian University of Health Sciences, Department of Neurology from January 15, 2017 to March 15 2018. Inclusion criteria: 18 to 65 years old; multiple sclerosis diagnosis confirmed by updated McDonald Diagnostic Criteria (2017). Spasticity was evaluated using the MAS scale. Urination disorders assessed by OABSS scale and obstructive symptom questionnaire. Quality of life assessed with SF-Qualiveen scale. The analysis was performed with SPSS statistical package. Results: Men and women with increased spasticity had a higher EDSS score. Women with spasticity were older, men had longer disease duration. Patient with higher spasticity had more intense bladder dysfunction. Patients with spasticity were associated with greater incidence of urinary incontinence with retention. Patients with spasticity had higher urinary tract infection rate and lower glomerular filtration. Patients with spasticity had more obstructive urinary tract symptoms. Patients with higher spasticity had a lower quality of life. Conclusions: The relationship between spasticity and investigated objects support the hypothesis that spasticity is associated with an increase in the external urethral tone that leads to urinary retention and its related complications.

Keywords: Multiple sclerosis; spasticity; urinary incontinence.