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Objective: To analyze the role of urodynamic dysfunctions as risk factors for recurrent urinary tract infections (rUTIs) in patients with multiple sclerosis (MS). Material and methods: We conducted a prospective cohort study of 170 patients with MS who underwent a urodynamic study due to lower urinary tract symptoms. Patients were followed for one year, and 114 (84 women [74%] and 30 men [26%]; mean age 49 years) completed the study. Clinical variables and urodynamic findings (free uroflowmetry, cystometry, and pressure-flow study results) were recorded. Results indicated rUTIs was present in 37 patients (32%). Statistical analysis was performed using Fisher’s exact test, chi-square test, Student’s t-test, and multivariate regression analysis. Results: In univariate analysis, significant differences were observed between patients with and without rUTIs for the following clinical variables: symptom progression time, MS duration, Expanded Disability Status Scale score, and MS type. Regarding urodynamic findings, significant differences were observed in maximum flow rate (Qmax) (lower in patients with rUTIs), voided volume, bladder voiding efficiency, stress urinary incontinence (SUI) (greater rUTI frequency in affected patients), detrusor pressure at maximum flow, and bladder contractility index score. Multivariate analysis identified the urodynamic factors: low Qmax [Odds Ratio (OR) = 0.90 and SUI (OR = 2.95) as the independent predictors of rUTs. Conclusions: Two urodynamic variables: Qmax and SUI, are independent risk factors for rUTIs in MS patients. These two variables might be associated with Pelvic floor dysfunctions.

Objective: To analyze the role of urodynamic dysfunctions as risk factors for recurrent urinary tract infections (rUTIs) in patients with multiple sclerosis (MS). Material and methods: We conducted a prospective cohort study of 170 patients with MS who underwent a urodynamic study due to lower urinary tract symptoms. Patients were followed for one year, and 114 (84 women [74%] and 30 men [26%]; mean age 49 years) completed the study. Clinical variables and urodynamic findings (free uroflowmetry, cystometry, and pressure-flow study results) were recorded. Results indicated rUTIs was present in 37 patients (32%). Statistical analysis was performed using Fisher's exact test, chi-square test, Student's t-test, and multivariate regression analysis. Results: In univariate analysis, significant differences were observed between patients with and without rUTIs for the following clinical variables: symptom progression time, MS duration, Expanded Disability Status Scale score, and MS type. Regarding urodynamic findings, significant differences were observed in maximum flow rate (Qmax) (lower in patients with rUTIs), voided volume, bladder voiding efficiency, stress urinary incontinence (SUI) (greater rUTI frequency in affected patients), detrusor pressure at maximum flow, and bladder contractility index score. Multivariate analysis identified the urodynamic factors: low Qmax [Odds Ratio (OR) = 0.90 and SUI (OR = 2.95) as the independent predictors of rUTs. Conclusions: Two urodynamic variables: Qmax and SUI, are independent risk factors for rUTIs in MS patients. These two variables might be associated with Pelvic floor dysfunctions. [ABSTRACT FROM AUTHOR]

Introduction. Spinal Dysraphism is present in nearly 1,500 newborns each year in Mexico. Of these, 95% will show neurogenic urinary bladder, most frequent disease attended at CRIT Estado de Mexico Urology Service. Objective. To evaluate urinary bladder function alteration (urodynamics and cystography), and upper urinary tract deterioration (renal ultrasound and serum creatinine) in children with Spinal Dysraphism Material and methods. Observational, descriptive, retrospective and transversal study. Patients from 5 to 18 years old, with at least one urodynamic study, retrograde cystography, serum creatinine, and renal ultrasound. From January, 2005 to December, 2008. Statistical analysis: Mann-Whitney U Test, Kruskal-Wallis Test and linear association. Results. According to the anatomical level of presentation the patient distribution (n = 97) was lumbar 47% (46), thoracic 39% (38), thoracolumbar 12% (12), and cervical 1% (one). 93% received some form of treatment. Urodynamics showed normal findings in 5%, hyperactive bladder 68% and hypoactive bladder 27%. Hyperactive bladder presented significant lower bladder capacity. 22 patients showed vesicoureteral reflux, 10 of them of high grade (IV/V). 78 (80%) children had a normal renal ultrasound. The median serum creatinine was 0.57 mg/dL (± 0.25 SD). A positive but weak linear association between hydronephrosis and vesicoureteral reflux vs. creatinine level was shown (R2 = 0.051 y R2 = 0.024). Conclusions. A linear positive association between ultrasonographic findings, serum creatinine and vesicoureteral reflux was demonstrated (an increased upper urinary tract deterioration with higher levels of vesicoureteral reflux was observed). There were no associations between renal function deterioration and urodynamic bladder findings. [ABSTRACT FROM AUTHOR]