Multiple sclerosis (MS) is an inflammatory central nervous system disease that presents a wide range of clinical manifestations depending on the time and course of the disease. Lower urinary tract symptoms (LUTS) are frequently seen in MS and significantly affect the quality of life of individuals depending on the location of MS plaques. These symptoms are more than just a hygienic and social problem; they can directly affect an individual's mobility level. This study aims to determine the frequency of LUTS in patient with MS (PwMS) and to examine the impact of these symptoms on mobility using a hierarchical model.

The study was designed as a cross-sectional study. The sample consisted of 90 PwMS diagnosed by expert neurologist. Descriptive information such as age, gender, BMI, and disease duration was collected through a demographic data form. The presence of lower urinary tract symptoms in the participants was assessed using the Core Lower Urinary Tract Symptom Score (CLSS). The level of disability of the participants was assessed using the Expanded Disability Status Scale (EDSS). The functional mobility levels of the participants were assessed using the Timed Up and Go Test (TUG).

The mean age of the participants was 39.57±9.29 years, and 74.4% of the participants were female. The average duration of illness for the participants was 97.80 months. The average TUG duration for individuals was determined to be 8.22±2.31 seconds, and the total CLSS score was 6.31±5.21. Only 5.6% of participants reported no LUTS, while 16.7% reported one symptom and 12.2% reported two symptoms. 65.6% of patients had three or more urinary symptoms. The most common of these symptoms are nocturia (76.7%), urgency (50%) and incomplete emptying (46.7%), while the least common are straining (11.1%), urethral pain (22.2) and bladder pain (28.9). According to the results of the hierarchical regression analysis, Model 3 (Storage) has the highest explanatory power for the dependent variable (TUG) (R2 = 0.529, Adj. R2 = 0.488, F = 12.898, p < 0.001). While age emerged as a significant predictor in all models, it was found to have the strongest effect in Model 1 (β = 0.427, p = 0.002). The EDSS score became the variable with the highest regression coefficient from the moment it was included in the models and showed a strong positive effect on the dependent variable (β = 0.594 for Model 2). In the third step, LUTS variables were added separately: the explanatory power of the model increased when storage was added (R²=0.529) and storage was found to be significant independently (B=0.163, p=.019); EDSS retained its significance (p<.001). In contrast, voiding (p=.499) and pain (p=.198) were not significant predictors in the added models.

Multiple LUTS can be observed in PwMS. Nocturia and urgency are particularly common LUTS in the MS population. Finally, after controlling for demographic characteristics in PwMS, it was found that clinical disability levels (EDSS) and specifically storage symptoms had a significant predictive power on TUG.

This study highlights that LUTS in PwMS are not isolated events, but usually present as a complex combination of multiple symptoms. The MS population should be comprehensively assessed for the presence, frequency, and variety of LUTS, and their impact on functionality. Clinicians must remain vigilant regarding the multifactorial nature of these symptoms, prioritizing the management of storage-related dysfunction to better preserve or improve the functional independence of patients.

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Al Dandan, H. B., Coote, S., & McClurg, D. (2020). Prevalence of Lower Urinary Tract Symptoms in People with Multiple Sclerosis: A Systematic Review and Meta-analysis. International journal of MS care, 22(2), 91–99. https://doi.org/10.7224/1537-2073.2019-030
Seddone, S., Marturano, M., Bientinesi, R., Lucchini, M., Bassi, P., Mirabella, M., & Nociti, V. (2021). Lower urinary tract disorders in multiple sclerosis patients: prevalence, clinical features, and response to treatments. Neurourology and urodynamics, 40(6), 1500–1508. https://doi.org/10.1002/nau.24687

Continence 19S (2026) 102810
DOI: 10.1016/j.cont.2026.102810