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The following is a summary of “Algorithms for the first-line management of bladder, bowel and sexual dysfunction in multiple sclerosis: Present and future,” published in the November 2024 issue of Neurology by Tota et al.
People with multiple sclerosis (PwMS) often experience neurogenic bladder, bowel, and sexual dysfunction (SD), which can significantly affect their QoL and overall health.
Researchers conducted a retrospective study to evaluate current management algorithms for neurogenic lower urinary tract dysfunction (NLUTD), neurogenic bowel dysfunction (NBD), and SD in PwMS.
They conducted a systematic review on PubMed in June 2024, searching for articles that included the terms ‘algorithm/s’ or ‘management/ing’ in the title or abstract, combined with ‘multiple sclerosis’ and keywords related to NLUTD, NBD and SD. A total of 15 studies on NLUTD, one on SD, and no studies on NBD were included in the review.
The results showed that the studies underscored the significant impact of urinary and bowel symptoms on QoL and morbidity in PwMS. A few studies provided algorithms addressing NLUTD for first-line physicians, focusing on key priorities for MS care. No algorithms were explicitly found for NBD, and screening for SD was noted to require a structured assessment to provide appropriate treatment options.
They concluded that neurogenic bladder, bowel, and SD are often underdiagnosed and undertreated in PwMS. Simple management algorithms for first-line physicians could improve patient care and QoL and ensure proper specialist referrals.
Source: msard-journal.com/article/S2211-0348(24)00460-7/abstract
