Speakers' abstracts
Bladder management in MS: new guidelines
Fowler C, Consultant, National Hospital for Neurology and Neurosurgery, London
Bladder symptoms in MS are common and distressing but also highly amenable to treatment. A meeting of stakeholders involved in patients' continence care including neurologists, urologists, primary care, MS nurses and nursing groups was recently convened to formulate a UK consensus for management. NICE criteria were used for producing recommendations based on a review of the literature and expert opinion. It was agreed that in the majority of cases, successful management could be based on a simple algorithm which includes using reagent sticks to test for urine infection and measurement of the post micturition residual urine volume. This is in contrast to published guidelines from other countries which recommend cystometry. Throughout the course of their disease, patients should be offered appropriate management options for treatment of incontinence, the mainstay of which is antimuscarinics medication in combination if necessary with clean intermittent self catheterisation. The evidence for other measures including physiotherapy, alternative strategies aimed at improving bladder emptying, other medications and detrusor injections of BoNT-have been reviewed. These recommendations for the management of urinary tract infections as well as bladder problems as part of severe disability will be presented.
Continence panel
Harrison S - Consultant Urologist, Pinderfields Hospital, Wakefield
MacLeod N - MS Specialist Nurse, Western General Hospital, Edinburgh
Mangnall J - Continence Advisor, Rotherham PCT