Upper urinary tract abnormalities in multiple sclerosis patients with urinary symptoms

Objective: To determine the prevalence of upper urinary tract complications in multiple sclerosis (MS) patients with urinary symptoms, and to determine if an association exists between degree of physical impairment and upper urinary tract complications. Design and Setting: A cohort study of MS patients seeking treatment at a freestanding, university-affiliated rehabilitation hospital. Participants: A referred sample of 48 patients with MS, exacerbation-free for 6 months with symptoms of neurogenic bladder dysfunction. For each patient, demographic data, disease characteristics, and urologic history was obtained. Using the Kurtzke Expanded Disability Status Scale (EDSS), participants were divided into a control (EDSS < 7) and study (EDSS ≥) group. Intervention: Ultrasound examination of the upper urinary tract. Main Outcome Measure: Significant MS-related abnormalities of the upper urinary tract. Results: Ten of 48 patients (21%) had significant MS-related upper urinary tract abnormalities, which were evenly distributed between control and study groups. In the more disabled study group, abnormalities were associated with the symptom of urinary hesitancy ( p < .05) and form of bladder management ( p < .05). Conclusion: Routine screening for upper urinary tract complications appears indicated in a select group of MS patients with urinary symptoms.