This study included 602 patients with MS. 474 (78.7%) and 128 (21.3%) of the subjects were women, men, and 415 (68.9%), 149 (24.8%), and 38 (6.3%) of the subjects were married, single, and divorced and widowed respectively. Moreover, 244(40.5%), 214(35.5%), 145(24.0%) had university degrees, high school and Secondary school or below, respectively. 128(21.2%), 378(62.7%), 45(7.5%), 52(8.6%) were employed, housewife, retired and disabled, and unemployed, respectively. The mean and SD of the age of the participants, duration of MS, and disability score were 35.45 ± 9.08 years, 7.63 ± 5.56 years, , and 2.45 ± 2.11, respectively. Moreover, 16(2.7%), 173 (28.6%), 247 (41.0%), 167 (27.7%) were in the group below 20 years, 20-29 years ,30-39 years, high school and 40-50 years., respectively. According to the EDSS, 432 (71.6%) patients had mild, 151(25.0%) patients had moderate, and 20 (3.4%) patients had severe disability. In addition, 459(76.1%), 116 (19.3%), and 28(4.6%) of the patients had a clinical relapsing-remitting course, progressive, and CIS, respectively.
Of the 602 patients with MS, mild, moderate, and severe urinary symptoms had a rate of 58.8%, 32.6%, and 6.8%, respectively. The prevalence rate of mixed, irritative, and obstructive symptoms was 52.2%, 25.5%, and 6.5% respectively. Moreover, 15.4% of women and 17.1% of men lacked any urinary symptoms. The prevalence rates of mixed, irritative, and obstructive symptoms were 51.1%, 28.1%, and 4.5% among women and 56.5%, 16.3%, and 10.1% among men, respectively. Chi-square test showed a statistically significant difference between the two groups in this respect (P = 0.020). The prevalence of urinary symptoms differed significantly between age groups of below or above 30 years and also among individuals with different educational levels. There was no significant difference among subjects with and without urinary symptoms in terms of marital status, and body mass index (BMI) (Table 1).
Among the patients, 19.7%, 4.6%, and 15.0% of the individuals with, respectively, mild, moderate, and severe disability had no urinary symptoms. In addition, 44.0%, 72.8%, and 75.0% of the patients with, respectively, mild, moderate, and severe disability had concurrent irritative and obstructive symptoms, and chi-square test showed a significant difference among the three groups (P < 0.001). No urinary symptoms were observed among 19.5%, 16.5%, and 9.4% of patients with the illness duration of, respectively, less than 5 years, 5-10 years, and more than 10 years. Moreover, 43.3%, 50.5%, and 67.5% of the patients with the illness duration of, respectively, less than 5 years, 5-10 years, and more than 10 years had concurrent irritative and obstructive symptoms (mixed), and chi-square test indicated a significant difference among the three groups (P = 0.001). No urinary symptoms were observed among 32.1%, 17.4%, and 5.2% of the patients with, respectively, CIS, relapsing-remitting MS (RRMS), and progressive MS. Furthermore, 32.1% of the patients with CIS had only irritative symptoms, and 48.1% and 75.0% of the patients with, respectively, RRMS and progressive MS had simultaneous irritative and obstructive symptoms, and chi-square test showed two significant differences among the three groups (P < 0.001) (Table 2).
The mean score of all dimensions of QOL, except for health changes, as well as the combined dimensions of physical and mental health in the LUTS-free group was significantly higher compared to the group with LUTS. There was a statistically significant difference in all dimensions, except for health changes (Independent t test, P < 0.050), among the two groups (Table 3). Moreover, the mean score of all dimensions of QOL, except for health changes and satisfaction with sexual function, as well as the combined dimensions of physical and mental health in the mild group was significantly higher compared to the group with moderate and severe LUTS. There was a statistically significant difference in all dimensions, except for health changes and satisfaction with sexual function (ANOVA, P < 0.050), among the three groups (Table 4). Logistic regression analysis also suggested a higher possibility of urinary problems among patients with MS and a higher age [3.273 (1.083-9.860); P = 0.035] (Table 5).