Severity and Characteristics of Overactive Bladder Condition in MS: An Ancillary Analysis of the NARCOMS Registry Data

Background: Bladder dysfunction is a common problem in MS and has been associated with a reduced quality of life, and may interfere with daily activities. Dysfunction can range from minor to severe and specialist care may often be required. 

Objectives: To establish the prevalence of self-report bladder dysfunction in a large MS population and assess factors associated with the severity of dysfunction, such as MS disability level and urology-related care.

Methods: Participants included respondents to the Fall 2005 NARCOMS update survey bladder function questions, who were US residents with no surgical alteration to the bladder. Urology related care measures and healthcare utilization were also assessed. Participants were classified as: No overactive bladder (No-OAB), Dry-OAB (urgency without leakage) or Wet-OAB (urgency with leakage). Statistical comparisons were made with Chi-square tests.

Results: Of the 8,380 respondents 61.6% reported Wet-OAB, 14.7% Dry-OAB and 23.7% reported No-OAB. Those with Wet-OAB had a longer median disease duration (12 years) compared to Dry-OAB (9 yrs) and No-OAB (8 yrs; p<0.0001). Some leakage related to activity, coughing or sneezing was reported by 65.0% in the Wet-OAB group, and to a lesser extent in the otherwise Dry-OAB (23.5%) and No-OAB (26.5%; p<0.0001) groups. A higher proportion of participants with Wet-OAB reported moderate or worse disability on the PDDS (80.7%) compared to Dry-OAB (65.4%) and No-OAB (48.4%; p<0.0001). Participants with Wet-OAB were most likely to report ever having a UTI (63.4%), compared to Dry-OAB (61.9%) and No-OAB (56.2%; p<0.0001) and most likely to report taking prophylactic antibiotics (Wet-OAB [9.7%], Dry-OAB [4.8%] or No-OAB [5.3%; p<0.0001]). Specialty care in the prior 6 months by a Urologist was reported by 22.5% of participants with Wet-OAB, compared to 15.2% with Dry-OAB and 12.0% with No-OAB (p<0.0001), with more participants among Wet-OAB group reporting ever having seen a Urologist (51.1%) compared to Dry-OAB (40.9%) and No-OAB (28.6%; p<0.0001).

Conclusions: Wet-OAB is associated with a longer duration of MS disease and overall MS disability, as well as a higher prevalence of UTI occurrence and prophylactic antibiotic usage.  Those reporting Wet-OAB reported higher urologist care than those without Wet-OAB, though the overall rate of urology care for any OAB was low.

Acknowledgements: NARCOMS is supported in part by the CMSC and the Foundation of the CMSC.  This study was supported by Allergan, Inc.