Anna Malykhina
University of Colorado Denver,U.S.A
Title: Neurogenic bladder dysfunction in neurological disorders
Biography
Biography: Anna Malykhina
Abstract
Multiple sclerosis (MS) is an auto-inflammatory disease of the CNS that affects approximately 400,000 people in the United States alone and more than 2.1 million people worldwide. Lower urinary tract symptoms (LUTS) are present in 70–80% of MS patients, causing great discomfort and having a negative effect on the quality of the individual’s social, occupational and sexual life. Neurogenic LUTS include urinary urgency, urinary incontinence, nocturia, urinary hesitancy, overflow incontinence, a sensation of incomplete emptying, urinary retention, and a weak urinary stream. The most common symptom reported by MS patients in remission is urgency of micturition followed by urinary frequency. In approximately 10–15% of patients, bladder symptoms are present at the onset of MS when there may be few lesions identified in the spinal cord and/or brain. In patients with established MS, bladder symptoms are prevalent and often associated with symptoms of bowel and sexual dysfunction. Identification and development of urinary tract protective therapies in neurological diseases has proven to be a major challenge, because of an already substantial LUT compromise at the time of presentation to a urologist. Therapeutic approaches for neurogenic LUTS primarily include anti-muscarinic drugs as well as intermittent self-catheterization to facilitate complete bladder emptying. Given the unfavorable side effect profile of these medications and poor persistence on therapy, as well as the burden of catheterization on a debilitated population, more innovative therapeutics are desperately needed. In the quest for therapeutics, a greater understanding of the pathophysiology and patterns of disease is also required.