Does Pons Plaque Affect Urination and Urodynamic Functions in Multiple Sclerosis?

Abstract

OBJECTIVE: More than %80 of Multiple Sclerosis (MS)

patients are observed to have urinary system dysfunctions during the

course of their ilnesses. Neuronal control of the bladder is highly

complicated. Autonomic and somatic nerve systems have to function in

coordination. It is known that bladder functions are controlled by medial

frontal lobe in the cerebral hemispheres and by pontine reticular

formation in the brainstem.

A i m: In MS, the relationship between the localization of the plaque and

bladder dysfunction is not clear. The aim of this study was to identify the

effects of the plaque in pons on the clinical and urodynamic findings by

comparing the patients having periventricular and pontine plaques and

the ones having only periventricular plaque

METHODS: Between May 2001 to June 2003,25 MS patients

of whom 15 were females and 10 males studied. The mean age of the

patients was 44, while the mean disease duration was 57.2 month. Mean

EDSS was 1.82(0-3). The patients were divied into two groupes. Group I

(12 cases) consisted of those having periventricular and pons plaque,

whereas Group II (13 cases) consisted of those having only periventricular

plaque. All patients who had spinal cord plaque excluded. Urodynamic

evaluation were done.

RESULTS: Comparing the plaque localization and the urodynamic results

did not reveal any statistical difference between the groups (p=0.841).

The symptoms observed in the groups were studied with respect to their

relation with the urdynamic findings. All the symptomatic cases in Group

I and half of the symptomatic cases in Group II had abnormal urodynamic

findings. Among the asymptomatic cases, %71.4 of Group I and %40 of

Group II had normal urodynamic findings.

CONCLUSION: As a result, existance of pontine plaque in those having

periventricular plaque does not affect the urologic symptoms and

urodynamic functions.