1. Progressive Multiple Sclerosis and incontinence:
A survey study of the patients’ perspective on symptoms and impact
Nikki Cotterill1, Carole Copestake2, Iain Weir3,
Marcus Drake1, Christine Norton4, Alastair Wilkins2
1. Bristol Urological Institute 2. North Bristol NHS Trust 3. University of the West of England 4. King’s College
This project was funded by an MS Society Junior Fellowship award
BACKGROUND
Approximately 107,000 people in the UK have a diagnosis of Multiple Sclerosis.
Associated bladder and bowel problems are common.
Accurate data regarding severity of MS and incontinence is lacking.
RECRUITMENT
Four week survey study.
Eight UK Neurology centres.
MS Society website.
June 2014 to December 2015.
Inclusion criteria:
18 years or older
Diagnosis of primary/secondary progressive MS
Symptomatic urinary (UI) and/or anal incontinence (AI)
Ability to complete questionnaires
QUESTIONNAIRES
Self-report questionnaire
Area of evaluation
ICIQ-UI Short Form
UI symptoms
ICIQ-B
AI symptoms and impact on QoL
FAMS
Functional assessment of MS
ICIQ-LUTSqol
Impact on QoL from UI
ICIQ-F/MLUTSsex
Gender-specific sexual matters
EQ-5D-3L
Generic profile of health status
RESULTS
200 participants
(153 females, 47 males)
FAMS domain
Mean score (SD, range)
Overall score
86.0
(29.5, )
Symptoms
17.0
(6.1, 2-28)
Emotional well-being
15.5
(7.2, 0-28)
Family/social wellbeing
17.7
(6.4, 0-28)
AI/FI
Reported symptom (%,n)
Overall
97%
FI (flatus excluded)
79%
Frequent flatus
65%
Frequent liquid stool
42%
Frequent solid stool
31% UI
Reported symptom (%,n)
Overall
92%
Severe/very severe
41%
Frequent
53%
Combined UI/AI
81%
CONCLUSIONS
Varying severity of MS symptoms reported with moderate impact on daily function.
Incontinence levels are reportedly high in both severity and frequency.
Bladder and bowel continence difficulties often occur in combination.
Clinicians should actively enquire about all incontinence regardless of disease severity or gender.