Bladder Dysfunction in Multiple Sclerosis

Multiple sclerosis (MS) involves focal neural demyelmation with relative sparing of axons and resultant impaired nerve conduction. Demyelination commonly affects the posterolateral columns of the spinal cord, with the majority of patients having cervi cal cord involvement. Forty percent of patients have lumbar cord involvement and 18 percent have sacral cord involvement. The cerebral cortex and midbram may also be affected. Lesions in any of these areas can affect voiding function. Between 50 percent and 90 percent of all MS patients will experience bladder dysfunction during the course of the disease (1-3), and voiding dysfunction is the presentmg symptom m 10 percent of patients (3). Therefore, it is imperative that one consider MS in the differential diagnosis of patients with significant voiding complaints.