Micturitional complaints in patients with multiple sclerosis (MS) affect in the course of the disease 80 % of the patients. The incidence of complaints correlates most frequently with the extent of spastic paraparesis of the lower extremities. By urodynamic examination it is possible to evaluate vesicouretral coordination, the capacity of the urinary bladder and the presence of urinary residue. Based on the results of the examination symptomatic treatment can be planned. Between January 1, 1997 and June 30, 2000 201of our 1,500 patients in the Centre for MS (144 women and 57 men) were subjected to urological examination. The duration of the disease at the time of the examination was on average 12.9 ± 11.1 years. Of these patients 93 (46 %) were in remitting phase (RR) of MS, 80 patients (40 %) in the stage of secondary progression (SP) and 28 patients (14 %) in the stage of primary progression (PP). The most frequent subjective problem of patients was imperative micturition – 11 cases (57 %), imperative micturition with incontinence – 43 cases (22 %), incontinence – 6 cases (3 %) and prolonged micturition with incomplete emptying – 35 cases (18 %). Urodynamic examination revealed in 48 patients (24 %), hyperreflexia of the detrusor, in 125 patients (63 %), hyperreflexia of the detrusor with outflow obstruction, in 13 patients (6.5 %) a hypoactive detrusor and in 11 patients (5.5 %) isolated hyperactivity of the urethra, in 2 patients the finding was normal (1 %). The best effect was obtained by treatment started in patients with the RR form of MS with a duration of the disease up to 10 years, the smallest effect was found in the secondary progressive form or MS (40 %) where however the favourable therapeutic effect may be reached by intermittent (auto)catheterization or epicystostomy (depending on the type of complaints). From the results the necessity of early urodynamic examination and subsequent treatment in patients with MS ensues preferably from the initial complaints of patients with the remittent form of the disease.

        Key words: micturitional complaints, multiple sclerosis