INTRODUCTION: This studys first aim is to assess the prognostic characteristics of people with multiple sclerosis (pwMS) who initially had bowel-bladder dysfunction and to present their relationship with the transition to secondary progressive MS (SPMS). The second aim of the study is to show the frequency of relapses that affect bowel-bladder functions as one of the first reasons for hospital admission among pwMS. The third aim is to present the frequency of relapses affecting bowel-bladder functions in pwMS throughout the disease process.
METHODS: Study data of this retrospective cohort study were obtained from longitudinal follow-up data of pwMS who were followed up since 1996 in an Dokuz Eylul University Hospital MS Unit. A total of 3448 pwMS were assessed for eligibility, and those who met the eligibility criteria were included in the study. Included pwMS were assessed for relapse affecting bowel and bladder functions and transition from the Relapsing-Remitting MS (RRMS) course to the SPMS course.
RESULTS: A total of 459 (13.3%) pwMS experienced at least one relapse affecting their bowel-bladder functions at any point in their disease process, and these bowel-bladder functions were affected in 129 of 3,448 (3.7%) patients during their first relapse. Affected bowel and bladder functions during the first relapse were ineffective in predicting the transition to the SPMS course (p>0.05). The initial Expanded Disability Status Scale score (p=0.001), age of disease onset (p<0.001), age at the start of progression (p=0.035), and spinal cord involvement in the functional systems affected at first admission (p=0.013) effectively predicted the transition to the SPMS course.
DISCUSSION AND CONCLUSION: Bowel and bladder dysfunction is a common but poorly-addressed clinical presentation. It is observed even at the onset of the disease. Although the affected bowel and bladder function at first relapse is not effective in predicting the transition from the RRMS course to the SPMS course, the onset of the disease at a young age, severe disability at the beginning, and the spinal origin of the first symptom are promising predictors. Bowel and bladder dysfunction and factors predicting the transition to the SPMS course should be addressed in many ways.