Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia-A Cross-Sectional Study

Abstract

Background: Lower urinary tract dysfunction (LUTD) is caused by neurogenic factors that could lead to permanent injury in affected patients, and therefore result in substantial annual healthcare expenses. LUTD is very prevalent in multiple sclerosis (MS) patients and has a drastic impact on their quality of life (QOL). This study aimed to assess the effect of LUTD on the QOL of Saudi MS patients.

Methods: A cross-sectional study was carried out in Saudi Arabia using a self-administered questionnaire that included the World Health Organization Quality of Life (WHOQOL-BREF) and LURN Symptom Index (LURN SI-29). Data were analyzed and presented as frequencies and percentages.

Results: There were 428 patients who participated in this study; 270 were females and 158 were males. Most of the patients received a low score in all sections of the LURN part of the questionnaire. The highest scores (urgent need to urinate and excessive urination at night) were recorded in the urgency domain (47.20 ± 36.88) rather than the nocturia domain (44.74 ± 32.91). Meanwhile, the lowest score (complete control of bladder) was recorded in the incontinence domain (22.80 ± 26.80). For the WHOQOL-BREF score, the highest score (more social stability) was in the social domain (65.07 ± 21.16 for females, 60.41 ± 21.54 for males), and the lowest score (less psychological stability) was in the psychological domain (46.36 ± 9.84 for females, 46.20 ± 10.03 for males). However, there was no significant association between the four domains of the WHOQOL-BREF and the gender of the MS patients.

Conclusions: LUTD is significantly associated with a lowered quality of life. Therefore, patients are recommended to consult with and be evaluated by appropriately experienced healthcare providers and clinicians. This ensures that the patients receive the best advice, accurate and effective treatment, and long-term analysis that can lead to an improvement in their quality of life.

Keywords: Saudi Arabia; healthcare surveys; lower urinary tract dysfunction; multiple sclerosis; quality of life.

Figure 1

LURN SI-29 scale and subscale total scores by sex. (The line in the box and the lower and upper edges of the box indicate the median and the 25th (Q1) and 75th (Q3) percentiles, respectively. The whiskers represent the minimum (extends to Q1 − 1.5 * interquartile range) and maximum (extends to Q3 + 1.5 * interquartile range). Circles indicate outliers.) LURN SI-29, Lower Urinary Tract Dysfunction Research Network Symptom Index-29.

Figure 2

The WHOQOL-BREF scale and subscale total scores by sex (270 females and 158 males). (The line in the box and the lower and upper edges of the box indicate the median and the 25th (Q1) and 75th (Q3) percentiles, respectively. The whiskers represent the minimum (extends to Q1 − 1.5 * interquartile range) and maximum (extends to Q3 + 1.5 * interquartile range). Circles indicate outliers.).