1
|
Campetella M, Marino F, Gavi F, Gandi C, Ragonese M, Coluzzi S, Racioppi M, Sacco E, Bientinesi R. Classification and management of sexual dysfunctions in multiple sclerosis patients: A review of current literature. Urologia 2023; 90:605-610. [PMID: 37387303 DOI: 10.1177/03915603231183751] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Multiple sclerosis (MS) is the most frequent neurological disease in young adults, with the greatest incidence between age of 30 and 35 years. Sexual dysfunctions (SDs) are frequent, but are often underestimated in patients with MS, and can have a significantly high impact on patient's quality of life. Aim of this review is to summarize sexual dysfunctions in male and female MS patients and to illustrate current and emerging therapeutic options for treatment.
Collapse
Affiliation(s)
- Marco Campetella
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Filippo Gavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Carlo Gandi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Mauro Ragonese
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - Simone Coluzzi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Marco Racioppi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - Emilio Sacco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - Riccardo Bientinesi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| |
Collapse
|
2
|
Brouchet M, Teng M, Chesnel C, Lagnau P, Amarenco G, Hentzen C. Expectations about the management of sexual dysfunction in women with multiple sclerosis and association with clinical characteristics. Mult Scler Relat Disord 2023; 79:104950. [PMID: 37657309 DOI: 10.1016/j.msard.2023.104950] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/10/2023] [Accepted: 08/20/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) is common in women with multiple sclerosis (MS) and affects their quality of life. OBJECTIVES The primary aim is to assess their expectations concerning SD management. The secondary aim is to identify if expectations were associated with specific patient's characteristics. METHODS All women with MS who underwent a urodynamic assessment in a neuro-urology clinic and had a standardized assessment of SD expectations between June 2020 and November 2022 were retrospectively screened. Demographic data and assessment of bladder, bowel, and sexual dysfunctions with validated questionnaires were collected. RESULTS One hundred and sixty-seven patients were included in the study (mean age 47.9 ± 12.5 years). Expectations on SD information or management were reported by 112 (67.1%) patients. Interest in SD information and management was less frequent after menopause (56% vs 80%, p = 0.004), and in those with EDSS>6 (49% vs 74%, p = 0.03) and progressive type of MS (54% vs 71% p = 0.003). In multivariate analysis, the progressive type of MS was the only criterion related to a lack of interest (OR=2.9 IC95% [1.09; 7.72]). CONCLUSIONS Women with MS have high expectations on treatment and information about SD. A systematic screening of SD expectations should be encouraged.
Collapse
Affiliation(s)
- Maximilien Brouchet
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France.
| | - Maëlys Teng
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France
| | - Camille Chesnel
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France
| | - Philippe Lagnau
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France
| | - Gérard Amarenco
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France
| | - Claire Hentzen
- GRC 01, Service de Neuro-Urologie, Green Group of Clinical Research in Neuro-Urology AP-HP, Sorbonne Université, AP-HP, Hôpital Tenon, 4, rue de la Chine, Paris F-75020, France
| |
Collapse
|
3
|
Audrey SB, Marion R, Béatrice M, Stéphane V, Katelyne H. Sexual Dysfunction in Women With Multiple Sclerosis: Expectations Regarding Treatment and Information, and Utility of the SEA-MS-F Questionnaire. Sex Med 2022; 10:100502. [PMID: 35378440 PMCID: PMC9177879 DOI: 10.1016/j.esxm.2022.100502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction Sexual dysfunction is a common complaint in female with multiple sclerosis (MS), however this problem is not often considered in the medical and psychological care. Aim To evaluate expectations regarding treatment and information for sexual dysfunction in women with multiple sclerosis using the SEA-MS-F (Sexual Dysfunction Management and Expectations Assessment in Multiple sclerosis - Female) questionnaire, and to gain an understanding of the relationship between their expectations, demographic factors and medical factors known to promote sexual dysfunction. Methods A prospective epidemiological, descriptive, analytical, multicentre study was carried out over 15 months on adult women suffering from MS. The SEA-MS-F was used to evaluate expectations regarding their sexuality and sexual activity. Main Outcome Measure 87 women were included. Mean age was 47 years and the mean time since MS diagnosis was 14 years. Results 59.8% reported sexual dysfunction, but only 22.4% of the participants had raised the subject with a professional. With regards to expectations, 68% of the women wanted information about sexual dysfunction and 80% of women with sexual difficulties wanted treatment. High expectations correlated with the presence of sexual dysfunction, a regular sexual partner and with milder ambulatory handicap. There were no correlations between expectations and age, time since MS diagnosis, fatigue or being postmenopausal. The SEA-MS-F questionnaire was perceived as useful by 63.4% of the women and 90% felt that it could help doctors to treat sexual dysfunction. Conclusion To date, the SEA-MS-F is the only questionnaire validated in women with MS for the evaluation of sexual expectations and in the present study the women felt strongly that it represented a useful way for them to introduce and then discuss the subject of their sexual dysfunction with their doctor. Audrey S-B, Marion R, Béatrice M, et al. Sexual Dysfunction in Women With Multiple Sclerosis: Expectations Regarding Treatment and Information, and Utility of the SEA-MS-F Questionnaire. Sex Med 2022;10:100502.
Collapse
Affiliation(s)
- Schreiber-Bontemps Audrey
- Services de Médecine Physique et de Réadaptation et Explorations fonctionnelles, CHRU de Brest, Brest, France.
| | - Roquet Marion
- Services de Médecine Physique et de Réadaptation et Explorations fonctionnelles, Centre de Perharidy, Fondation Ildys Roscoff, Roscoff, France
| | - Médée Béatrice
- Services de Médecine Physique et de Réadaptation et Explorations fonctionnelles, CHRU de Brest, Brest, France
| | - Verdun Stéphane
- Biostatisticien, équipe de Délégation à la Recherche Clinique et à l'Innovation, Groupement des Hôpitaux de l'Institut Catholique de Lille & réseau coopératif de recherche en SSR FEHAP, Lille, France
| | - Hubeaux Katelyne
- Services de Médecine Physique et de Réadaptation et Explorations fonctionnelles, Centre de Perharidy, Fondation Ildys Roscoff, Roscoff, France
| |
Collapse
|
4
|
Seddone S, Marturano M, Bientinesi R, Lucchini M, Bassi P, Mirabella M, Nociti V. Lower urinary tract disorders in multiple sclerosis patients: prevalence, clinical features, and response to treatments. Neurourol Urodyn 2021; 40:1500-1508. [PMID: 34082481 PMCID: PMC8361667 DOI: 10.1002/nau.24687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/07/2021] [Indexed: 11/15/2022]
Abstract
Aims Lower urinary tract symptoms are common in multiple sclerosis (MS) and have a great impact on quality of life. We evaluated prevalence and characteristics of urological symptoms in a cohort of patients with MS. Methods This is a cross‐sectional study conducted on consecutive patients with MS attending our Center in 2018. We evaluated prevalence, clinical features, and response to symptomatic treatments of lower urinary tract disorders; we investigated the relationship between them and clinical and demographic features. Data of urodynamic studies were also collected. Results In our cohort of 806 patients, the overall prevalence of urological symptoms was 52.9% and urgency was the most frequent symptom (59.4%). Symptomatic patients had a higher disability, a longer disease duration, a later age at onset, and a greater mean age at the time of evaluation. Urinary disorders were more frequent in patients with progressive disease and in women. About 41.8% of patients were under treatment for the urological disorder and 81.5% of them reported an improvement of symptoms. Conclusion Urinary disorders in patients with MS have a high prevalence. An early and correct characterization of types of symptoms and an early and targeted therapeutic strategy are essential to improve the patient's quality of life and avoid future complications.
Collapse
Affiliation(s)
- Silvia Seddone
- Department of Ageing, Neurosciences, Head-neck and Orthopaedics Sciences, Institute of Neurology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Monia Marturano
- Department of Woman and Child Health and Public Health Sciences, Urogynecology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Bientinesi
- Department of Medical and Surgical Sciences, Urological Clinic, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Lucchini
- Department of Ageing, Neurosciences, Head-neck and Orthopaedics Sciences, Institute of Neurology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Pierfrancesco Bassi
- Department of Medical and Surgical Sciences, Urological Clinic, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Mirabella
- Department of Ageing, Neurosciences, Head-neck and Orthopaedics Sciences, Institute of Neurology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Viviana Nociti
- Department of Ageing, Neurosciences, Head-neck and Orthopaedics Sciences, Institute of Neurology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
5
|
Krysko KM, Bove R, Dobson R, Jokubaitis V, Hellwig K. Treatment of Women with Multiple Sclerosis Planning Pregnancy. Curr Treat Options Neurol 2021; 23:11. [PMID: 33814892 PMCID: PMC8008016 DOI: 10.1007/s11940-021-00666-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW We review data available for treatment of multiple sclerosis (MS) before, during, and after pregnancy. We present recent data on disease-modifying therapies (DMT) before/during pregnancy and while breastfeeding, with treatment recommendations. RECENT FINDINGS Observational data support the safety of injectable DMTs (glatiramer acetate, interferon-beta) for use in pregnancy, while some oral DMTs might be associated with fetal risk. Monoclonal antibodies (mAbs) before pregnancy such as rituximab or natalizumab likely do not pose significant fetal risks, but can cross the placenta with neonatal hematological abnormalities if given in the second trimester or later. Breastfeeding is associated with decreased risk of postpartum relapses. Finally, injectables and mAbs likely have low transfer into breastmilk. SUMMARY Many women with MS do not require DMTs during pregnancy, although injectables could be continued. For women with highly active MS, cell-depleting therapies could be given before conception, or natalizumab could be continued through pregnancy, with monitoring of the fetus. Women should be encouraged to breastfeed, and those with higher relapse risk could consider injectables or mAbs while breastfeeding. Further data on safety of DMTs around pregnancy are needed. Maximizing function through non-pharmacologic approaches is complementary to DMTs. Special considerations for pregnancy and DMTs during the COVID-19 pandemic are needed.
Collapse
Affiliation(s)
- Kristen M. Krysko
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158 USA
- Division of Neurology, Department of Medicine, St. Michael’s Hospital, University of Toronto, 9 Donnelly Wing South, 30 Bond Street, Toronto, Ontario M5B 1W8 Canada
| | - Riley Bove
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158 USA
| | - Ruth Dobson
- Preventive Neurology Unit, Wolfson Institute of Preventive Neurology, Queen Mary University of London, Charterhouse Square, London, UK
- Department of Neurology, Royal London Hospital, Whitechapel, London, UK
| | - Vilija Jokubaitis
- Department of Neuroscience, Monash University, Melbourne, VIC Australia
- Department of Neurology, Alfred Health, Melbourne, VIC Australia
| | - Kerstin Hellwig
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
6
|
Declemy A, Chesnel C, Charlanes A, Le Breton F, Sheikh Ismael S, Amarenco G. Short-term reproducibility of cystometry in multiple sclerosis patients. Prog Urol 2020; 31:169-174. [PMID: 33309471 DOI: 10.1016/j.purol.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the reproducibility of detrusor activity cystometric pattern in multiple sclerosis (MS) patients, which is poorly documented in the medical literature, by means of successive filling. METHODS We conducted a prospective study in MS patients; cystometry was repeated twice at 5minutes of interval if a detrusor overactivity before 300mL of filling was observed. Thus, 3 successive cystometries were analysed. The following characteristics were recorded: detrusor maximum pressure (Pmax), volume at the first involuntary detrusor contraction (IDC), maximum cystometric capacity (MCC), pressure at the first IDC, the existence of an overactive detrusor classified as phasic or terminal. RESULTS We included 31 patients (19 women and 12 men); only 6 patients were naïve-treatment, the mean EDSS was: 5.3 (±1.6) and the mean age was 48.4 (±12.5) years. All the patients had an overactive detrusor for each cystometry. The reproducibility was good for all the parameters (range ICC between 0.7 and 0.83). CONCLUSION Quantitative and qualitative cystometric data have a good reproducibility in MS patients with detrusor overactivity before 300mL of filling. LEVEL OF PROOF 3.
Collapse
Affiliation(s)
- A Declemy
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France.
| | - C Chesnel
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - A Charlanes
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - F Le Breton
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - S Sheikh Ismael
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| | - G Amarenco
- Sorbonne université, GRC 01, GREEN - groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, 75020 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 75020 Paris, France
| |
Collapse
|
7
|
Jacq C, Hubeaux K, Ramanantsitonta J. [Multiple sclerosis and intermittent self-catheterization]. Prog Urol 2020; 31:195-203. [PMID: 33277166 DOI: 10.1016/j.purol.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/24/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Lower urinary tract dysfunctions are frequent in patients with multiple sclerosis (MS). These disorders impair quality of life and can cause urological complications. In cases of urinary retention or incomplete bladder emptying, clean intermittent self-catheterization is the preferred option where possible. OBJECTIVE To identify data concerning the use of intermittent self-catheterization by patients with MS. BIBLIOGRAPHIC SOURCE A review was done using Medline/Pubmed with selection of articles in either English or French. The key words were: « multiple sclerosis and intermittent catheterization, self-catheterization, neuro-urology/urinary guidelines, continent stoma, continent vesicostomy». STUDY SELECTION Studies were selected if they concerned either multiple sclerosis exclusively or with a majority of cases concerning MS. RESULTS Intermittent self-catheterization is recommended and commonly used in patients with MS. Studies are rare in this specific population. Questions still remain about indications and practicalities in this disease. Indications must be individually evaluated according to symptoms and complications. The use of self-catheterization can improve symptomatology or quality of life, however, global urinary management is necessary. Urinary infection is the most frequently reported side effect. The teaching of self-catheterization should take into account physical and cognitive impairment. Due to the developing nature of the pathology, indications and the patients' ability to carry out self-catheterization should be regularly assessed. LIMITATIONS The search was limited to a single bibliographic source and studies are rare. CONCLUSION Further studies are necessary to increase knowledge of self-catheterization specificities in MS patients compared to other neurogenic patients.
Collapse
Affiliation(s)
- C Jacq
- Service de MPR, site d'Auray, Centre hospitalier Bretagne Atlantique, 20, boulevard du Général-Maurice-Guillaudot, BP 70555, 56017 Vannes cedex, France.
| | - K Hubeaux
- Service d'explorations fonctionnelles, site de Perharidy, Fondation Ildys, route de Perharidy, 29680 Roscoff, France
| | - J Ramanantsitonta
- Service de MPR, site d'Auray, Centre hospitalier Bretagne Atlantique, 20, boulevard du Général-Maurice-Guillaudot, BP 70555, 56017 Vannes cedex, France
| |
Collapse
|
8
|
Krysko KM, Graves JS, Dobson R, Altintas A, Amato MP, Bernard J, Bonavita S, Bove R, Cavalla P, Clerico M, Corona T, Doshi A, Fragoso Y, Jacobs D, Jokubaitis V, Landi D, Llamosa G, Longbrake EE, Maillart E, Marta M, Midaglia L, Shah S, Tintore M, van der Walt A, Voskuhl R, Wang Y, Zabad RK, Zeydan B, Houtchens M, Hellwig K. Sex effects across the lifespan in women with multiple sclerosis. Ther Adv Neurol Disord 2020; 13:1756286420936166. [PMID: 32655689 PMCID: PMC7331774 DOI: 10.1177/1756286420936166] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating central nervous system disorder that is more common in women, with onset often during reproductive years. The female:male sex ratio of MS rose in several regions over the last century, suggesting a possible sex by environmental interaction increasing MS risk in women. Since many with MS are in their childbearing years, family planning, including contraceptive and disease-modifying therapy (DMT) counselling, are important aspects of MS care in women. While some DMTs are likely harmful to the developing fetus, others can be used shortly before or until pregnancy is confirmed. Overall, pregnancy decreases risk of MS relapses, whereas relapse risk may increase postpartum, although pregnancy does not appear to be harmful for long-term prognosis of MS. However, ovarian aging may contribute to disability progression in women with MS. Here, we review sex effects across the lifespan in women with MS, including the effect of sex on MS susceptibility, effects of pregnancy on MS disease activity, and management strategies around pregnancy, including risks associated with DMT use before and during pregnancy, and while breastfeeding. We also review reproductive aging and sexual dysfunction in women with MS.
Collapse
Affiliation(s)
- Kristen M Krysko
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, 675 Nelson Rising Lane, Suite 221, San Francisco, CA 94158, USA
| | - Jennifer S Graves
- Department of Neurosciences, University of California San Diego, UCSD ACTRI, La Jolla, CA, USA
| | - Ruth Dobson
- Preventive Neurology Unit, Wolfson Institute of Preventive Neurology, Queen Mary University of London, London, UK
| | - Ayse Altintas
- Department of Neurology, School of Medicine, Koc University, Istanbul, Turkey
| | - Maria Pia Amato
- Department NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy
| | - Jacqueline Bernard
- Department of Neurology, Oregon Health Science University, Portland, OR, USA
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania, "Luigi Vanvitelli", Naples, Italy
| | - Riley Bove
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco CA, USA
| | - Paola Cavalla
- Department of Neuroscience and Mental Health, City of Health and Science University Hospital of Torino, Turin, Italy
| | - Marinella Clerico
- Department of Clinical and Biological Sciences, University of Torino, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Teresa Corona
- Clinical Laboratory of Neurodegenerative Disease, National Institute of Neurology and Neurosurgery of Mexico, Mexico City, Mexico
| | - Anisha Doshi
- Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, University College London (UCL) Institute of Neurology, London, UK
| | - Yara Fragoso
- Multiple Sclerosis & Headache Research Institute, Santos, SP, Brazil
| | - Dina Jacobs
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Vilija Jokubaitis
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia
| | - Doriana Landi
- Department of Systems Medicine, Multiple Sclerosis Center and Research Unit, Tor Vergata University and Hospital, Rome, Italy
| | | | | | | | - Monica Marta
- Neurosciences and Trauma Centre, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Luciana Midaglia
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Suma Shah
- Department of Neurology, Duke University, Durham, NC, USA
| | - Mar Tintore
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Rhonda Voskuhl
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Yujie Wang
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Rana K Zabad
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Burcu Zeydan
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Maria Houtchens
- Department of Neurology, Partners MS Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kerstin Hellwig
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
9
|
Masmoudi R, Aissi M, Halouani N, Fathallah S, Louribi I, Aloulou J, Amami O, Frih M. [Female sexual dysfunction and multiple sclerosis: A case-control study]. Prog Urol 2018; 28:530-535. [PMID: 30076093 DOI: 10.1016/j.purol.2018.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To compare the scores of the different dimensions of sexual function of women with multiple sclerosis to a group of control women and to identify possible factors associated with sexual dysfunction in women with multiple sclerosis. METHODS This is a descriptive and analytical case-control study. Twenty-six women with multiple sclerosis were compared to 26 control women matched for age and socioeconomic status. The evaluation focused on demographic and clinical data. Patients with multiple sclerosis were evaluated by Expanded Disability Status Scale (EDSS) for functional status, by Female Sexual Function Inventory (FSFI) for sexual function and by Beck Depression Inventory-Short Form (BDI-DF) for severity of depression. RESULTS Our results confirmed the high prevalence of sexual dysfunction among patients with multiple sclerosis (69.2%) compared to controls (26.9%) (P=0.002). Sexual desire, arousal and orgasm were the most altered sexual phases in our study. Total FSFI, and FSFI subscale scores (sexual desire, arousal, lubrication, orgasm and satisfaction) were lower in women with multiple sclerosis compared with controls. The analytical study showed that in women with multiple sclerosis, the total FSFI score was correlated with age (rs=-0.68; P<0.001), duration of marriage (rs=-0.57; P=0.002), level of disability (rs=-0.45; P=0.021) and BDI-SF score (rs=-0.51; P=0.008). FSFI score was also associated to low education level (P=0.02) and urinary dysfunction (P=0.04). CONCLUSION Our study highlighted the importance of sexual dysfunction in women with multiple sclerosis. The inclusion of this aspect in the clinical assessment will improve the quality of life of these patients. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- R Masmoudi
- Service de psychiatrie « B », CHU Hedi-Chaker, route El Ain 0,5km, 3000 Sfax, Tunisie.
| | - M Aissi
- Service de neurologie, CHU Fattouma-Bourguiba, Monastir, Tunisie
| | - N Halouani
- Service de psychiatrie « B », CHU Hedi-Chaker, route El Ain 0,5km, 3000 Sfax, Tunisie
| | - S Fathallah
- Service de psychiatrie, CHU Fattouma-Bourguiba, Monastir, Tunisie
| | - I Louribi
- Service de neurologie, CHU Fattouma-Bourguiba, Monastir, Tunisie
| | - J Aloulou
- Service de psychiatrie « B », CHU Hedi-Chaker, route El Ain 0,5km, 3000 Sfax, Tunisie
| | - O Amami
- Service de psychiatrie « B », CHU Hedi-Chaker, route El Ain 0,5km, 3000 Sfax, Tunisie
| | - M Frih
- Service de neurologie, CHU Fattouma-Bourguiba, Monastir, Tunisie
| |
Collapse
|
10
|
Babany F, Hamdoun S, Denys P, Amarenco G. [Sexuality of patients with neurological disability: Perception of healthcare professionals of a neurologic rehabilitation hospital unit]. Prog Urol 2016; 26:1229-1234. [PMID: 27746037 DOI: 10.1016/j.purol.2016.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 11/24/2022]
Abstract
Sexual disorders are common after neurological diseases. The reconstruction of sexuality is a major issue after neurologic disability. Why is this topic not covered in rehabilitation medicine except specialized service? The aim of this pilot study was to assess the perception of the healthcare professionals (HCPs) and to understand why this topic was not addressed. We conducted a pilot, observational, monocentric study from February to March 2016 in HCPs from a neurologic rehabilitation hospital unit. RESULTS The sexuality was essential for 14/28 (50%) HCPs in general and for 7/28 (25%) in neurologic disability. The hospital inhibits sexuality rebuilding in 21/28 (75%). The question of exercise of sexuality in hospital was considered as legitimate question for 13/28 (46%). Twenty-third (82%) have talked about sexuality with patients or colleagues, 5/19 (27%) thought that their response was satisfactory when patient asked about it. The question of sexuality had been managed for 10/28 (36%) during their training; 22/28 (79%) considered it was a prime importance for their job. CONCLUSION In this monocentric study, sexuality was often poorly managed in rehab center. The professionals did not dare talking about it with patients and answered with difficulties when they are asked about sexual disorders. They were not trained for this topic. A specialized medical education in hospital and during studies would be of great value to improve neurologic rehabilitation of these patients. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- F Babany
- Service de médecine physique et réadaptation, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
| | - S Hamdoun
- Service de médecine physique et réadaptation, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - P Denys
- Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, 92380 Garches, France
| | - G Amarenco
- Service de neuro-urologie, hôpital Tenon, 75020 Paris, France
| |
Collapse
|
11
|
Stress Urinary Incontinence in Women With Multiple Sclerosis. Int Neurourol J 2016; 20:224-231. [PMID: 27706005 PMCID: PMC5083823 DOI: 10.5213/inj.1630490.245] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/18/2016] [Indexed: 11/20/2022] Open
Abstract
Purpose To report the prevalence and risk factors of stress urinary incontinence (SUI) and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS). Methods We conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS) during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected. SUI was defined as incontinence during cough, or any effort. A maximum urethral closure pressure less than 30 cm H2O defined intrinsic sphincter deficiency. Results We included 363 women with a mean age of 46.7±10.8 years and a mean disease duration of 12.9±8.7 years. The incidence of relapsing remitting MS, a secondary progressive form, and a primary progressive form was 60.6%, 32.8%, and 6.6%, respectively. The prevalence of SUI was 31.4%. The prevalence of intrinsic sphincter deficiency was 1.4% and 0.8% of these patients had a SUI (P=0.300). In a multivariate analysis, women with a SUI had significantly higher birth weight (P=0.030), a pelvic organ prolapse (P=0.021), urgent urinary incontinence (P=0.006), a lower EDSS score (P=0.019), and a weaker containing effort (P<0.001). Conclusions The prevalence of SUI in women with MS was 31.4%. This symptom could affect the quality of life of women with MS.
Collapse
|
12
|
|
13
|
Maladies neurodégénératives 2014–2019 : un plan sans périnée. Prog Urol 2015; 25:435-6. [DOI: 10.1016/j.purol.2015.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 11/24/2022]
|