Multiple sclerosis

What is the disease?

Multiple sclerosis is a chronic neurological condition that belongs to the category of demyelinating diseases.Multiple Sclerosis is described as inflammatory demyelination.These are conditions in which there is a gradual destruction of the myelin, the covering of the nerves that helps protect them as well as the transmission of nerve impulses.The result is a disturbance in the transmission of impulses along a nerve, i.e. its dysfunction.The name multiple sclerosis refers to the multiple scars (sclerosis) on the myelin.

The cause of MS is still not clear. Rather, its appearance is determined by a combination of environmental and genetic factors.Also, an immune-type “attack” of the organism on the myelin sheath of the nerves is recognized.

From the moment the disease manifests itself, there are periods of remission and exacerbation. Relapses of the disease are usually unpredictable and can occur without warning.But it seems that they happen more often in spring and summer, after various infections, after physical or psychological stress, during the first months of pregnancy or after childbirth.

Multiple sclerosis usually occurs in adults between the ages of 20 and 40 and is significantly more common among women and among whites. It affects approximately 2.5 million people worldwide. In the general population the probability of disease is approximately 1:1000.

Heredity seems to play a role in its occurrence – people who have a sibling with the disease have a 1-3% chance of developing it themselves. Also, studies on twins showed that the corresponding percentage is around 30%.

MS affects the neurons, cells in the brain and spinal cord that send information, create thought and perception, and allow the brain to control the body.What the person with MS feels depends on what is connected to the nerve. If it is a nerve axon in the spine that carries sensory signals from the legs up, then that person may experience tingling or numbness. If it carries motor signals down to the leg muscles, then weakness can occur. If it is nerves in the brain that are responsible for, for example, the sense of balance, it may be impossible to walk without leaning to one side.

The clinical picture does not have the same severity for everyone, and the symptoms in the initial episodes are usually transient and mild and do not motivate the patient to seek medical help.

At some point in the course of the disease, most MS patients, both men and women, will develop urinary symptoms.The most common are urinary urgency, frequency, and urge incontinence, symptoms that can be roughly explained in terms of underlying detrusor overactivity and incomplete bladder emptying.

Symptoms from the genitourinary system are rare at the beginning of the disease but become very common during its course.They have a particularly negative effect on the quality of life of the patients, as well as the family and carers. Depending on the studies, 46 to 78% of patients will develop urinary symptoms, while disorders are more common in the primary progressive form of the disease. Their diagnosis does not always require a specialist or special tests while most of the symptoms can now be treated by neurologists with conservative means, while the special contribution of the urologist is needed when more aggressive diagnostic or therapeutic means are necessary.


There is currently no definitive cure for multiple sclerosis because there is no causal treatment for the disease. However, with existing treatments and various bladder management products (catheters), a large percentage of patients live a normal life, with relatively few problems.

Supportive measures such as physical therapy, occupational therapy, speech therapy, and kinesitherapy are also applied. Finally, it is recommended to adopt a healthy lifestyle with proper nutrition, exercise, avoiding stress, etc.