Alteraciones urinarias en la esclerosis múltiple

Abstract

We review the anatomical and physiological basis integrating and coordinating vesical sphincter function; the dynamics of micturition with its phases of filling and emptying, their coordination with the sphincters through the different centres and circuits of the nervous system; the physiopathology, in relation to the localization of the plaques of demyelination, of incontinence due to detrusor hyperreflexia, hyperreflexia with dyssynergia, hyperreflexia of the detrusor with hypoactivity of the detrusor during the emptying phase and finally due to areflexia. The symptomatology and clinical features vary from 60% to 80% in the different series of cases, depending on the time of evolution and degree to which the patients are affected, with a predominance of irritative rather than obstructive symptoms. The treatment, which requires precise classification of the disorders, is with anticholinergic drugs or alpha 1 blocking and myorelaxant drugs, surgery, neurostimulators, rehabilitation, catheterism, the use of absorbent and collectors, other techniques and therapies which are being developed, without forgetting measures to prevent complications.