Bladder Dysfunction and Disability in Persons Newly Diagnosed with Multiple Scleorsis

Thursday, May 29, 2014
Trinity Exhibit Hall
Tracy Flemming Tracy, OTR/L, MSCS, MSSMC , Rehabilitation, Tanner Center for MS, Birmingham, AL
Emily S Riser, MD , Neurology, Tanner Center for MS, Birmingham, AL
Bess Martin, PT, MSCS , Rehabilitation, Tanner Center for MS, Birmingham, AL


Neurogenic bladder occurs in 80% of persons diagnosed with MS causing repeated Urinary tract infections and possibly leading to progressive neurological impairments. Urinary urgency, incontinence, nocturia and urinary hesistancy are some issues associated with incoordination of the sphincter and urethra as well as disrupted transmission of electrical impulses that involve emptying the bladder. UTI’s have been associated with increase in cytokines and interferon production causing inflammation and leading to increase in disability from relapse thus causing concern for the newly diagnosed individual.


To determine incidence of bladder dysfunction in persons diagnosed with MS within one year, and to assess the correlation between disability and bladder dysfunction. To affirm the necessity of frequent bladder evaluation, even in newly diagnosed, to avoid UTIs and provide management in the early stages of dysfunction.


Persons with MS diagnosed within one year time frame participated in measurement of walking speed with the Timed 25ft Walk (T25’W) and post void residual (PVR) measured through a bladder ultrasound (BVI 3000).  T25’W values were considered normal at 2.2 seconds and PVR values of 1ml- 49ml.


Thirty-four newly diagnosed persons were studied. Thirteen persons (38%) presented with abnormal PVR and all thirteen subjects presented with slowed walking speeds compared to norm.  Four subjects out of thirteen performed the T25W’ requiring more than 5 seconds indicating significant impairment, while nine participants were under five seconds indicating minimal impairment of MS on ambulation. PVR ranged from 67ml to 300ml and T25’W scores ranged from 3.6 seconds to 6.8 seconds.


38% of persons newly diagnosed presented with neurogenic bladder with high risk of UTI. Abnormal PVR correlated with decreased walking speed in all (100%) of these newly diagnosed individuals with significant impairment in four (30%).  These findings necessitate early detection and intervention of bladder dysfunction to lessen occurrence of further disability.