PROBLEMES UROLOGIQUES CHEZ LES MALADES ATTEINTS DE SCLEROSE EN PLAQUES

Although the urological problems in multiple sclerosis are many, they have hitherto not received much attention. A report is presented of 25 patients subjected to complete urological evaluation. The pathophysiology is reviewed and a treatment suggested. It consists in reducing the activity of the parasympathetic system by an anticholinergic product of the type of propantheline, while increasing the activity of the sympathetic system with imipramine. The combination of 25 mg imipramine and 15 mg propantheline per day was administered to 36 patients. This treatment gave satisfactory results in patients with a hyperspastic bladder. In those with an atonic bladder, the results are much less good; the bladder has to be emptied by pressing on the abdomen. Only neglected neurological bladders render social life impossible, and sometimes cause renal dysfunction as well. These aspects should be kept in mind; all patients with M.S. should be subjected to a complete urological examination. CV.