Fluid Intake and Urinary Symptoms in Patients with Multiple Sclerosis.

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The relationship between fluid intake and lower urinary tract symptoms (LUTS) in individuals with neurogenic bladder is unknown. We aimed to investigate the association between fluid intake and urinary symptoms in patients with multiple sclerosis (MS).A prospective cross-sectional study of patients with multiple sclerosis presenting to the neurology office was conducted. Fluid intake and LUTS were assessed by the Questionnaire Based Voiding Diary and the American Urological Association Symptom Score, respectively. The relationship between fluid intake and LUTS was assessed using univariate and multivariate analysis.Among 200 individuals with multiple sclerosis, the mean total daily fluid intake was 2489 ml (SD 1883) and did not differ according to severity (i.e. mild, moderate, severe) of LUTS (F=0.30, p=0.74). Fluid restricting behavior to control urinary symptoms was reported by 47% of subjects. Subjects who reported fluid restricting were more likely to have worse urinary symptoms (OR 1.95, 95%CI 1.53-2.47, p<0.01). After accounting for fluid restricting behavior on multivariate analysis, there was a minimal relationship between caffeinated fluid intake and LUTS severity (OR 1.00 95%CI 1.00-1.01, p=0.01), and there was no relationship between total fluid intake and LUTS severity (OR 1.00 95%CI 1.00-1.00, p=0.07).Caffeinated fluid intake has a minimal effect on LUTS in patients with MS. On average, patients with MS do not excessively hydrate, and a considerable proportion of patients with MS restrict fluid intake to control their urinary symptoms. Fluid intake may not considerably contribute to LUTS in patients with MS.

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