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Sunday, June 6, 2010

Urinary Rehab Effective in MS discussed at CMSC-ACTRIMS

By Richard Robinson, Contributing Writer, MedPage Today
Published: June 05, 2010
Reviewed by 
Ari Green, MD; Assistant Professor, University of California, San Francisco.

SAN ANTONIO -- Individualized rehabilitation can improve urinary dysfunction in multiple sclerosis (MS) patients independent of disease duration or disability, according to a study presented here.

Over the study's 10-week course of treatment, post-void residual (PVR) fell from 160 mL to approximately 95 mL (p=0.010). "This is the first study that has shown that MS patients could reduce their post void residual," said lead author Maria Lopes de Carvalho, MD, of the AISM Rehabilitation Center in Genova, Italy.

Strength and coordination of the pelvic floor muscles was also increased -- "also a first," she said. Significant improvements were also seen in incontinence as recorded in patient diaries, as well as urge. Frequency was not improved, she said at the meeting of the Joint Consortium of Multiple Sclerosis Centers and America's Committee on Treatment and Research in Multiple Sclerosis.

"Over 80% of MS patients have symptoms of urinary dysfunction during the disease course," Lopes de Carvalho noted. Urinary symptoms, including urge, retention, hesitation, frequency, and incontinence, "can have a significant impact on patient quality of life."

Although rehabilitation has been recommended in expert guidelines, there are few studies about its effectiveness in MS, no studies on retention, and no studies examining whether effectiveness of therapy is dependent on disease duration or level of disability, she said.

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