| A UK consensus on the management of the bladder in multiple sclerosis. | |
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MedLine Citation:
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PMID: 19789195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Bladder symptoms in multiple sclerosis (MS) are common and distressing but also highly amenable to treatment. A meeting of stakeholders involved in patients' continence care, including neurologists, urologists, primary care, MS nurses and nursing groups was recently convened to formulate a UK consensus for management. National Institute for Health and Clinical Excellence (NICE) criteria were used for producing recommendations based on a review of the literature and expert opinion. It was agreed that in the majority of cases, successful management could be based on a simple algorithm which includes using reagent sticks to test for urine infection and measurement of the post micturition residual urine volume. This is in contrast with published guidelines from other countries which recommend cystometry. Throughout the course of their disease, patients should be offered appropriate management options for treatment of incontinence, the mainstay of which is antimuscarinic medications, in combination, if necessary, with clean intermittent self-catheterisation. The evidence for other measures, including physiotherapy, alternative strategies aimed at improving bladder emptying, other medications and detrusor injections of botulinum toxin A was reviewed. The management of urinary tract infections as well as the bladder problems as part of severe disability were discussed and recommendations agreed. |
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Authors:
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C J Fowler; J N Panicker; M Drake; C Harris; S C W Harrison; M Kirby; M Lucas; N Macleod; J Mangnall; A North; B Porter; S Reid; N Russell; K Watkiss; M Wells |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Postgraduate medical journal Volume: 85 ISSN: 1469-0756 ISO Abbreviation: Postgrad Med J Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-30 Completed Date: 2010-01-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0234135 Medline TA: Postgrad Med J Country: England |
Other Details:
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Languages: eng Pagination: 552-9 Citation Subset: IM |
Affiliation:
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Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. c.fowler@ion.ucl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Great Britain Humans Male Multiple Sclerosis / complications, physiopathology, therapy* Urinary Bladder, Overactive / etiology, physiopathology, therapy* Urinary Incontinence / etiology, physiopathology, therapy* Urinary Tract Infections / etiology, physiopathology, therapy* Urodynamics / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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