Skip to main content
Erschienen in: International Urogynecology Journal 4/2006

01.08.2006 | Original Article

Effects of pregnancy and child birth on urinary symptoms and urodynamics in women with multiple sclerosis

verfasst von: Aurélie Durufle, Sabine Petrilli, Benoit Nicolas, Sandrine Robineau, François Guillé, Gilles Edan, Philippe Gallien

Erschienen in: International Urogynecology Journal | Ausgabe 4/2006

Einloggen, um Zugang zu erhalten

Abstract

Objective

Our objective was to study the impact of pregnancy and delivery on vesicourethral disorders in patients with multiple sclerosis (MS).

Design and setting

We performed a retrospective chart review of records of women diagnosed with MS who were referred to the clinic.

Participants

A total of 102 women with MS (mean age of 44.7±11.4 years at the time of the study and mean age of 30.0±9.6 years at the onset of MS) participated in the study. The mean duration of disease was 15±10 years. The mean Expanded Disability Status Scale score was 5.4±1.8.

Main outcome measures

For each patient, demographic data, disease characteristics, urological and obstetrical history and urodynamic data were collected. Urinary disorders were classified as irritative (urinary urgency and frequency) or as obstructive (hesitancy of micturition, reduced or interrupted urinary stream and sensation of incomplete bladder emptying). Urodynamic study consisted of cystometry with continuous recording of urethral sphincter electromyography in 77 (76%) cases. Intravesical and intraurethral pressures were recorded. Bladder dysfunctions were classified into neurogenic detrusor overactivity or detrusor underactivity.

Results

Pregnancies and deliveries did not influence symptoms. Moreover, the only statistical difference from a urodynamic point of view was a decrease in maximal urethral closure pressure.

Conclusion

No interaction between pregnancy, delivery and urinary symptoms was found in this study. The effects of pregnancy and delivery seemed to be the same in women with MS and in healthy women, with a tendency towards a decrease in urethral pressure in women with MS.
Literatur
1.
Zurück zum Zitat Poser CM (1994) The epidemiology of multiple sclerosis: a general overview. Ann Neurol 36:180–193CrossRef Poser CM (1994) The epidemiology of multiple sclerosis: a general overview. Ann Neurol 36:180–193CrossRef
2.
Zurück zum Zitat Amarenco G, Kerdraon J, Denys P (1995) Bladder and sphincter disorders in multiple sclerosis. Clinical, urodynamic and neurophysiological study of 225 cases. Rev Neurol 151(12):722–730PubMed Amarenco G, Kerdraon J, Denys P (1995) Bladder and sphincter disorders in multiple sclerosis. Clinical, urodynamic and neurophysiological study of 225 cases. Rev Neurol 151(12):722–730PubMed
3.
Zurück zum Zitat Barbalias GA, Nikiforidis G, Liatsikos EN (1998) Vesicourethral dysfunction associated with multiple sclerosis: clinical and urodynamic perspectives. J Urol 160(1):106–111CrossRefPubMed Barbalias GA, Nikiforidis G, Liatsikos EN (1998) Vesicourethral dysfunction associated with multiple sclerosis: clinical and urodynamic perspectives. J Urol 160(1):106–111CrossRefPubMed
4.
Zurück zum Zitat Betts CD, D'Mellow MT, Fowler CJ (1993) Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 56(3):245–250PubMed Betts CD, D'Mellow MT, Fowler CJ (1993) Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 56(3):245–250PubMed
5.
Zurück zum Zitat Chancellor MB, Blaivas JG (1994) Urological and sexual problems in multiple sclerosis. Clin Neurosci 2(3–4):189–195PubMed Chancellor MB, Blaivas JG (1994) Urological and sexual problems in multiple sclerosis. Clin Neurosci 2(3–4):189–195PubMed
6.
Zurück zum Zitat Gallien P, Robineau S, Nicolas B, Le Bot MP, Brissot R, Verin M (1998) Vesico-urethral dysfunction and urodynamic findings in multiple sclerosis: a study of 149 cases. Arch Phys Med Rehabil 79(3):255–257CrossRefPubMed Gallien P, Robineau S, Nicolas B, Le Bot MP, Brissot R, Verin M (1998) Vesico-urethral dysfunction and urodynamic findings in multiple sclerosis: a study of 149 cases. Arch Phys Med Rehabil 79(3):255–257CrossRefPubMed
7.
Zurück zum Zitat Giannantoni A, Scivoletto G, Di Stasi SM et al (1999) Lower urinary tract dysfunction and disability status in patients with multiple sclerosis. Arch Phys Med Rehabil 80(4):437–441CrossRefPubMed Giannantoni A, Scivoletto G, Di Stasi SM et al (1999) Lower urinary tract dysfunction and disability status in patients with multiple sclerosis. Arch Phys Med Rehabil 80(4):437–441CrossRefPubMed
8.
Zurück zum Zitat Abramsky O (1994) Pregnancy and multiple sclerosis. Ann Neurol 36(Suppl):38–41CrossRef Abramsky O (1994) Pregnancy and multiple sclerosis. Ann Neurol 36(Suppl):38–41CrossRef
9.
Zurück zum Zitat Bernardi S, Grasso MG, Bertollini R, Orzi F, Fieschi C (1991) The influence of pregnancy on relapses in multiple sclerosis: a cohort study. Acta Neurol Scand 84(5):403–406PubMedCrossRef Bernardi S, Grasso MG, Bertollini R, Orzi F, Fieschi C (1991) The influence of pregnancy on relapses in multiple sclerosis: a cohort study. Acta Neurol Scand 84(5):403–406PubMedCrossRef
10.
Zurück zum Zitat Frith JA, Mc Leod JG (1988) Pregnancy and multiple sclerosis. J Neurol Neurosurg Psychiatry 51(4):495–498PubMedCrossRef Frith JA, Mc Leod JG (1988) Pregnancy and multiple sclerosis. J Neurol Neurosurg Psychiatry 51(4):495–498PubMedCrossRef
11.
Zurück zum Zitat Worthington J, Jones R, Crawford M, Forti A (1994) Pregnancy and multiple sclerosis: a 3-year prospective study. J Neurol 241(4):228–233CrossRefPubMed Worthington J, Jones R, Crawford M, Forti A (1994) Pregnancy and multiple sclerosis: a 3-year prospective study. J Neurol 241(4):228–233CrossRefPubMed
12.
Zurück zum Zitat Birk K, Ford C, Smeltzer S et al (1990) The clinical course of multiple sclerosis during pregnancy and the puerperium. Arch Neurol 47(7):738–742PubMed Birk K, Ford C, Smeltzer S et al (1990) The clinical course of multiple sclerosis during pregnancy and the puerperium. Arch Neurol 47(7):738–742PubMed
13.
Zurück zum Zitat Swash M, Snooks SJ, Chalmers DHK (1987) Parity as a factor in incontinence in multiple sclerosis. Arch Neurol 44(5):504–508PubMed Swash M, Snooks SJ, Chalmers DHK (1987) Parity as a factor in incontinence in multiple sclerosis. Arch Neurol 44(5):504–508PubMed
14.
Zurück zum Zitat Van Geelen JM, Lemmens WA, Eskes TK, Martin CB Jr (1982) The urethral pressure profile in pregnancy and after delivery in healthy nulliparous women. Am J Obstet Gynecol 144(6):636–649PubMed Van Geelen JM, Lemmens WA, Eskes TK, Martin CB Jr (1982) The urethral pressure profile in pregnancy and after delivery in healthy nulliparous women. Am J Obstet Gynecol 144(6):636–649PubMed
15.
Zurück zum Zitat Pigne A, Cotelle O, Kuntz D, Turlan JJ, Barrat J (1984) The importance of perineal rehabilitation following delivery. Acta Urol Belg 52(2):255–260PubMed Pigne A, Cotelle O, Kuntz D, Turlan JJ, Barrat J (1984) The importance of perineal rehabilitation following delivery. Acta Urol Belg 52(2):255–260PubMed
16.
Zurück zum Zitat Le Coutour X, Jouffroy C, Beuscart R, Renaud R (1984) Effect of pregnancy and delivery on the function of the cervico-urethral closure. J Gynecol Obstet Biol Reprod 13:771–774 Le Coutour X, Jouffroy C, Beuscart R, Renaud R (1984) Effect of pregnancy and delivery on the function of the cervico-urethral closure. J Gynecol Obstet Biol Reprod 13:771–774
17.
Zurück zum Zitat Tapp A, Cardozo L, Versi E, Montgomery J, Studd J (1988) The effect of vaginal delivery on the urethral sphincter. Br J Obstet Gynaecol 95(2):142–146PubMed Tapp A, Cardozo L, Versi E, Montgomery J, Studd J (1988) The effect of vaginal delivery on the urethral sphincter. Br J Obstet Gynaecol 95(2):142–146PubMed
18.
Zurück zum Zitat Poser CM, Paty DW, Scheinberg L et al (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231CrossRefPubMed Poser CM, Paty DW, Scheinberg L et al (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231CrossRefPubMed
19.
Zurück zum Zitat Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452PubMed Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452PubMed
20.
Zurück zum Zitat Weinshenker BG, Hader W, Carriere W, Baskerville J, Ebers GC (1989) The influence of pregnancy on disability from multiple sclerosis: a population-based study in Middlesex County, Ontario. Neurology 39(11):1438–1440PubMed Weinshenker BG, Hader W, Carriere W, Baskerville J, Ebers GC (1989) The influence of pregnancy on disability from multiple sclerosis: a population-based study in Middlesex County, Ontario. Neurology 39(11):1438–1440PubMed
21.
Zurück zum Zitat Nelson LM, Franklin GM, Jones MC (1988) Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 259(23):3441–3443CrossRefPubMed Nelson LM, Franklin GM, Jones MC (1988) Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 259(23):3441–3443CrossRefPubMed
22.
Zurück zum Zitat Sengler J, Sambuc R, San Marco P, Grosse D, Barbellion M (1993) Epidemiological survey of micturitional disorders in women. Ann Readapt Med Phys 36:251–257 Sengler J, Sambuc R, San Marco P, Grosse D, Barbellion M (1993) Epidemiological survey of micturitional disorders in women. Ann Readapt Med Phys 36:251–257
23.
Zurück zum Zitat Wheeler JS Jr, Siroky MB, Pavlakis AJ, Goldstein I, Krane RJ (1983) The changing neurourologic pattern of multiple sclerosis. J Urol 130(6):1123–1126PubMed Wheeler JS Jr, Siroky MB, Pavlakis AJ, Goldstein I, Krane RJ (1983) The changing neurourologic pattern of multiple sclerosis. J Urol 130(6):1123–1126PubMed
24.
Zurück zum Zitat Goldstein I, Siroky MB, Sax DS, Krane RJ (1982) Neurourologic abnormalities in multiple sclerosis. J Urol 128(3):541–545PubMed Goldstein I, Siroky MB, Sax DS, Krane RJ (1982) Neurourologic abnormalities in multiple sclerosis. J Urol 128(3):541–545PubMed
25.
Zurück zum Zitat Mac Lennan AH, Taylor AW, Wilson DH, Wilson D (2000) The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG 107:1460–1470PubMedCrossRef Mac Lennan AH, Taylor AW, Wilson DH, Wilson D (2000) The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG 107:1460–1470PubMedCrossRef
26.
Zurück zum Zitat Keskes J, Khairi H, Ben Said A, Hidar M, Pigne A (1988) Stress urinary incontinence in women. Epidemiologic inquiry. A Propos of 500 cases. J Gynecol Obstet Biol Reprod 17(4):453–460 Keskes J, Khairi H, Ben Said A, Hidar M, Pigne A (1988) Stress urinary incontinence in women. Epidemiologic inquiry. A Propos of 500 cases. J Gynecol Obstet Biol Reprod 17(4):453–460
27.
Zurück zum Zitat Samuelsson E, Victor A, Svardsudd K (2000) Determinants of urinary incontinence in a population of young and middle-aged women. Acta Obstet Gynecol Scand 79(3):208–215CrossRefPubMed Samuelsson E, Victor A, Svardsudd K (2000) Determinants of urinary incontinence in a population of young and middle-aged women. Acta Obstet Gynecol Scand 79(3):208–215CrossRefPubMed
28.
Zurück zum Zitat Thom DH, Van Den Eeden SK, Brown JS (1997) Evaluation of parturition and other reproductive variables as risk factors for urinary incontinence in later life. Obstet Gynecol 90(6):983–989CrossRefPubMed Thom DH, Van Den Eeden SK, Brown JS (1997) Evaluation of parturition and other reproductive variables as risk factors for urinary incontinence in later life. Obstet Gynecol 90(6):983–989CrossRefPubMed
29.
Zurück zum Zitat Wilson PD, Herbison RM, Herbison GP (1996) Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG 103:154–161CrossRef Wilson PD, Herbison RM, Herbison GP (1996) Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG 103:154–161CrossRef
Metadaten
Titel
Effects of pregnancy and child birth on urinary symptoms and urodynamics in women with multiple sclerosis
verfasst von
Aurélie Durufle
Sabine Petrilli
Benoit Nicolas
Sandrine Robineau
François Guillé
Gilles Edan
Philippe Gallien
Publikationsdatum
01.08.2006
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 4/2006
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-005-0012-7

Weitere Artikel der Ausgabe 4/2006

International Urogynecology Journal 4/2006 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.