Urodynamic Voiding Patterns in Multiple Sclerosis
Abstract
Aims: This study aimed to describe urodynamic voiding patterns in patients with MS (PwMS) using standardized assessments, and to compare the performance of the available nomograms and indices for obstruction and bladder contractility. Methods: PwMS and lower urinary tract symptoms underwent cystometry and pressure flow studies. Fluoroscopy findings were collected when available. Bladder contractility was assessed using the following parameters: bladder voiding efficiency (BVE), bladder contractility index (BCI), Watts factor (WF) for men, Projected Isovolumetric Pressure 1 (PIP1), the Valentini-Besson-Nelson (VBN) parameter k, and the urodynamic cut-off proposed by Gammie et al. for women. Obstruction was assessed using the bladder outlet obstruction index (BOOI) in men, and BOOIf in women. Agreement between the diagnosis of detrusor underactivity (DUA) and obstruction according to each parameter was assessed with weight kappa. Results: Ninety-seven PwMS were included (mean age 48.4 ± 10.5, 58 [60%] women, mean EDSS 3.9 ± 1.8). Sphincter dysfunction was observed in 68 patients (70%), most frequently detrusor sphincter dyssynergia (DSD) in 32 (33%), followed by non-relaxing urethral sphincter in 29 (30%), and delayed relaxation of the urethral sphincter in 7 (7%) PwMS. DUA was found in 22 PwMS (23%). All indices demonstrated low to moderate agreement with the diagnosis of DUA and obstruction in this cohort. Conclusion: Abnormal voiding patterns are common in PwMS, especially sphincter dysfunction. None of the developed indices for obstruction and DUA appear highly relevant in this specific neurogenic population.
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BibTeX
@article{chesnel2026urodynamic,
title = {{Urodynamic Voiding Patterns in Multiple Sclerosis}},
author = {Camille Chesnel and Nicolas Turmel and Maelys Teng and Emilie Blouet and Gérard Amarenco and Claire Hentzen},
journal = {Neurourology and Urodynamics},
year = {2026},
month = jun,
doi = {10.1002/nau.70348},
url = {https://hal.sorbonne-universite.fr/hal-05732794v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Urodynamic Voiding Patterns in Multiple Sclerosis
AU - Camille Chesnel
AU - Nicolas Turmel
AU - Maelys Teng
AU - Emilie Blouet
AU - Gérard Amarenco
AU - Claire Hentzen
PY - 2026
DA - 2026/06/22
JO - Neurourology and Urodynamics
DO - 10.1002/nau.70348
UR - https://hal.sorbonne-universite.fr/hal-05732794v1
AB - Aims: This study aimed to describe urodynamic voiding patterns in patients with MS (PwMS) using standardized assessments, and to compare the performance of the available nomograms and indices for obstruction and bladder contractility. Methods: PwMS and lower urinary tract symptoms underwent cystometry and pressure flow studies. Fluoroscopy findings were collected when available. Bladder contractility was assessed using the following parameters: bladder voiding efficiency (BVE), bladder contractility index (BCI), Watts factor (WF) for men, Projected Isovolumetric Pressure 1 (PIP1), the Valentini-Besson-Nelson (VBN) parameter k, and the urodynamic cut-off proposed by Gammie et al. for women. Obstruction was assessed using the bladder outlet obstruction index (BOOI) in men, and BOOIf in women. Agreement between the diagnosis of detrusor underactivity (DUA) and obstruction according to each parameter was assessed with weight kappa. Results: Ninety-seven PwMS were included (mean age 48.4 ± 10.5, 58 [60%] women, mean EDSS 3.9 ± 1.8). Sphincter dysfunction was observed in 68 patients (70%), most frequently detrusor sphincter dyssynergia (DSD) in 32 (33%), followed by non-relaxing urethral sphincter in 29 (30%), and delayed relaxation of the urethral sphincter in 7 (7%) PwMS. DUA was found in 22 PwMS (23%). All indices demonstrated low to moderate agreement with the diagnosis of DUA and obstruction in this cohort. Conclusion: Abnormal voiding patterns are common in PwMS, especially sphincter dysfunction. None of the developed indices for obstruction and DUA appear highly relevant in this specific neurogenic population.
SN - 0733-2467
SN - 1520-6777
ER -