ABSTRACT
Symptomatic therapy of bladder hyporeflexia in patients with multiple sclerosis by intermittent catheterization in cases of insufficient efficacy of alpha-adrenoblockers allows to prevent bacterial infection complications and chronic renal failure and to achieve significant improvement of quality of life of such patients.
Subject(s)
Adrenergic alpha-Antagonists/therapeutic use , Multiple Sclerosis/complications , Reflex, Abnormal/physiology , Urinary Bladder, Neurogenic/drug therapy , Humans , Treatment Outcome , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/physiopathology , Urodynamics/drug effectsABSTRACT
Urination disorders occur in 80% patients with multiple sclerosis (MS). Most common of them is detrusor-sphincter dyssynergia (DSD). Alpha1-adrenoblockers can relax the neck of the urinary bladder (UB) and urethral sphincters, thus eliminating dynamic obstruction, reducing resistance to urine flow and facilitating voiding. Our study assessed feasibility of using a selective alpha1A/D-adrenoblocker tamsulosin in MS-associated DSD. The choice of this alpha-adrenoblocker was based on its high safety profile in relation to cardiovascular system. The trial enrolled 28 patients (20 females and 8 males) with verified diagnosis of DSD. They were given tamsulosin (omnik) in a dose 0.4 mg/day (1 capsule) for 2 months. To the end of the trial quality of life raised in 96% patients. Occurrence of pollakiuria, number of imperative micturate urges diminished, the IPSS score decreased by 54%, QL index improved by 58%. There was also a decrease in the volume of the residual urine, amplitude of involuntary detrusor contractions, an increase in maximal volumic speed of urine flow, cystometric volume of the UB, mean urine volume in urination. Side effects were not registered. Thus, tamsulosin has a positive effect in voiding disorders in the presence of DSD associated with MS. This considerably improves quality of life of MS patients.
