Multiple sclerosis: prevalence and factors impacting bladder and bowel function in an Australian community cohort

Abstract

Purpose: To describe the prevalence and impact of bladder and bowel dysfunction on quality of life (QoL) in persons with multiple sclerosis (pwMS) in an Australian community cohort and to explore the relationships between commonly used continence measures.

Methods: Patients (N = 73) recruited from a tertiary hospital database, interviewed using standardised measures, based on the framework of International Classification of Functioning, Disability and Health.

Results: Of 73 participants (mean age 50 yrs, 73% female, 56% progressive MS), two thirds were bothered by urinary frequency whereas half reported urinary incontinence, and 14% bowel incontinence. Urinary problems impacted emotional health (31%), ability to perform household chores (22%) and physical recreation (28%), with detrimental impact on QoL. There was a significant relationship between symptoms, level of urogenital distress (rho = 0.74, p < 0.001) and impact of incontinence (rho = 0.68, p < 0.001). The single item of Urological Association Symptom Index assessing impact of bladder symptoms on QoL correlated significantly with all other bladder scales (rho = 0.60-0.74), making it a potential 'screening tool' to identify patients for further assessment.

Conclusion: Continence issues cause significant disability in pwMS. Improved awareness of currently available treatment options and clinically robust trials are needed to assess outcomes of continence intervention.