Real-world data on the prevalence and therapy of symptomatic bladder dysfunction in people with multiple sclerosis.

Authors

Mathia Kirstein, Niklas Frahm, David Ellenberger, Alexander Stahmann, Firas Fneish, Melanie Peters, Friedemann Paul, Clemens Warnke, Kerstin Hellwig, Peter Flachenecker, Klaus Berger, Michaela Mai, Michael Hecker, Uwe K Zettl

Published in

Therapeutic advances in neurological disorders. Volume 19. Pages 17562864261456559. Epub Jul 25, 2026.

Abstract

Bladder dysfunctions (BL-D) are common in people with multiple sclerosis (pwMS), significantly affecting daily life, infection risk, and survival. Nonetheless, BL-D are frequently stigmatized and inadequately addressed in clinical practice. To date, no comprehensive analysis of BL-D has been conducted in Germany.
To assess the prevalence of BL-D and its subtypes in a German cohort and identify associated factors and treatment patterns.
Data were analyzed from individuals enrolled in the German MS Register, aged ⩾18 with definite MS. Inclusion required ⩾3 visits and complete data on MS onset, diagnosis date, and BL-D status. BL-D were subclassified into urinary urgency, voiding dysfunction, bladder incontinence, and other BL-D. PwMS with different subtypes were compared regarding clinical, sociodemographic, and therapeutic characteristics and associated factors were identified using logistic regression.
The study cohort included 10,572 pwMS (71.7% female) with a mean age of 48.2 years, disease duration of 16.0 years, and median Expanded Disability Status Scale score of 2.0. BL-D was present in 38.0% of pwMS, with urinary urgency being the leading subtype (41.0%). Associations included older age, longer disease duration, progressive disease course, polysymptomatic onset, and receiving disease-modifying therapy. Interestingly, 37.1% of pwMS with BL-D received no bladder treatment, while 36.9% received pharmaceutical and 36.4% non-pharmaceutical bladder treatment.
The results highlight the clinical relevance and burden of BL-D in MS and provide first insights into subtype-specific differences in the German MS population. Providing appropriate BL-D care requires investigation into causal factors and a deeper understanding of the underlying reasons of the treatment gap.
Retrospective, cross-sectional study.

PMID:
42504388
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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