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Importance of Urodynamic Dysfunctions as Risk Factors for Recurrent Urinary Tract Infections in Patients with Multiple Sclerosis

Jesús Salinas-Casado1, Miguel Vírseda-Chamorro2*, Jorge Matías Guiu-Antem3

Objective: To analyses the role of urodynamic dysfunctions as risk factors for recurrent Urinary Tract Infections (rUTIs) in patients with Multiple Sclerosis (MS).

Material and methods: We carried out a prospective cohort study of 170 MS with lower urinary tract symptoms patients submitted to urodynamic study. Patients were followed for one year and 114 (84 women (74%) and 30 men (26%); mean age 49 years), completed the study. We recoded their clinical variables and urodynamic findings. The statistical tests used were Fisher´s exact test, chi square test, Student´s t-test and multivariate regression analysis.

Results: 37 patients (32%) had rUTIs, in univariate analysis. We found that patients with rUTIs had significant more symptom progression time, MS duration, Expanded Disability Status Scale score and greater frequency of Primary and Secondary Progressive MS types, lower maximum flow rate (Qmax), voided volume, bladder voiding efficiency, detrusor pressure at maximum flow, and bladder contractility index and greater frequency of Stress Urinary Incontinence (SUI). Multivariate analysis identified the urodynamic factors: Qmax Odds Ratio (OR)=0.90 and SUI (OR=2.95) as the independent predictors of rUTs.

Conclusion: Two urodynamic variables: Qmax and SUI are independent risk factors for rUTIs in MS patients. These two variables might be associated with Pelvic floor dysfunctions.