Urinary dysfunction in multiple sclerosis.

We aimed to determine the prevalence of urinary symptoms and complications in multiple sclerosis (MS) and to investigate the correlation of these symptoms and complications with urodynamic findings and disease characteristics (primary progressive, relapsing-remitting and secondary progressive). Fifty-two patients with MS were enrolled in the study. Patients were divided into three clinical types: primary progressive, relapsing-remitting and secondary progressive. Urological symptoms and complications were recorded. Each patient underwent a urodynamic investigation. Patients were evaluated for overall disability using the Expanded Disability Status Scale (EDSS). We found that 22 patients had primary progressive, 18 patients had relapsing-remitting and 12 patients had secondary progressive MS. Urgency was the most frequent urinary symptom (65%). Urinary infection was the most frequent urinary complication (15%). Detrusor hyperreflexia was found to be the main bladder dysfunction (27%). Detrusor sphincter dyssynergia was found in 25% of patients, and detrusor hyporeflexia was detected in 6%. No relationship was found between urinary symptoms and urodynamic abnormalities (p>0.05) and between urinary complications and urodynamic findings (p>0.05). No significant correlation was found between disease characteristics and urinary symptoms, urinary complications or urodynamic findings (p>0.05). We suggest that the assessment of urological symptoms and urodynamic evaluation is critical for evaluating quality of life in MS.

The effectiveness of a hydrogel dressing compared with standard management of pressure ulcers.

OBJECTIVE: To compare a hydrogel dressing with a conservative topical wound-care regimen (gauze with povidone-iodine) for the treatment of pressure ulcers. METHOD: A prospective study comprising 27 (24 male and three female) spinal-cord injury patients with a total of 49 pressure ulcers. Wounds were randomised into a treatment group (n=25) or control group (n=24). The primary outcome measure was the rate of wound healing (cm2/days). RESULTS: Healing rates in the treatment group were higher than in the control group, although this was not statistically significant. Some 84% of the wounds in the treatment group and 54% in the control group epithelialised, which was statistically significant (p=0.04). The mean healing time in the treatment group was 48 days compared with 45 days for the controls. CONCLUSION: Our results suggest that hydrogel occlusive wound dressings facilitate healing by promoting more rapid epithelialisation of pressure ulcers, when compared with conservative wound care.