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Aktuelle Neurologie 2010; 37(1): 10-17
DOI: 10.1055/s-0029-1223422
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Multiple Sklerose: Symptomatische Therapie von Blasen- / Mastdarm und Sexualfunktionsstörungen

Multiple Sclerosis: Symptomatic Therapy for Bladder-Bowel and Sexual DysfunctionG.  Ellrichmann1 , C.  Tönnes1 , A.  Schröder1 , R.  A.  Linker1 , R.  Gold1
  • 1Neurologische Klinik, St. Josef-Hospital, Ruhr-Universität Bochum
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
14. Dezember 2009 (online)

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Zusammenfassung

Die Multiple Sklerose beinhaltet bei langem oder chronischem Verlauf oft einen breiten Symptomkomplex, durch den Patienten in ihrem sozialen und privaten Leben eingeschränkt werden und durch den die Lebensqualität beeinträchtigt wird. Neben der immunmodulatorischen Therapie, durch die der zugrunde liegende Krankheitsprozess modifiziert wird, erfordert eine optimale symptomatische MS-Therapie eine enge interdisziplinäre Zusammenarbeit. Das Ziel symptomatischer Behandlungsansätze liegt darin, neben der unmittelbaren Symptomreduktion auch mögliche sekundäre Komplikationen zu vermeiden oder frühzeitig effektiv zu versorgen.

Abstract

Multiple sclerosis is a disease with a wide range of symptoms that restrict the patients' social and private lives and often affect their quality of life. Despite immunomodulating pharmacotherapy providing a means of controlling the underlying disease process, optimal disease management of MS symptoms requires symptomatic therapy and a multidisciplinary treatment. Symptomatic treatment should aim to reduce disability and prevent secondary complications that may result from existing disabilities.

Schlüsselwörter

Multiple Sklerose - Blasen- / Darmstörung - Sexualfunktionsstörung - symptomatische Therapie

Keywords

multiple sclerosis - bowel and bladder dysfunction - sexual dysfunction - symptomatic therapy

Literatur

  • 1 Henze T, Pette M, Rieckmann P. Symptomatische Therapie der Multiplen Sklerose. Aktuelle Therapieempfehlungen Multiple Sklerose Therapie Konsensus Gruppe (MSTKG). August 2004
    PubMedGoogle Scholar
  • 2 Kurtzke J F. A new scale for evaluating disability in multiple sclerosis.  Neurology. 1955;  5 580-583
    CrossrefPubMedGoogle Scholar
  • 3 Kurztke J F. Rating neurological impairment in multiple sclerosis: an expended disability status scale (EDSS).  Neurology. 1983;  33 1444-1452
    CrossrefPubMedGoogle Scholar
  • 4 Sipe J C, Knobler R L, Braheny S L. et al . A neurological rating scale (NRS) for use in multiple sclerosis.  Neurology. 1984;  34 1368-1372
    CrossrefPubMedGoogle Scholar
  • 5 Kurtzke J F. A proposal for a uniform minimal record of disability in multiple sclerosis.  Acta Neurol Scand. 1981;  64 110-129
    CrossrefPubMedGoogle Scholar
  • 6 International Federation of Multiple Sclerosis .Minimal Record of Disability for Multiple Sclerosis, National Multiple Sclerosis Society of the United States. New York; 1985
    PubMedGoogle Scholar
  • 7 Athwal B S, Berkley K J, Hussain I. et al . Brain responses to changes in bladder volume and urge to void in healthy men.  Brain. 2001;  124 369-377
    CrossrefPubMedGoogle Scholar
  • 8 DasGupta R, Fowler C J. Sexual and urological dysfunction in multiple sclerosis: better understanding and improved therapies.  Curr Opin Neurol. 2002;  15 271-278
    CrossrefPubMedGoogle Scholar
  • 9 Betts C, D'Mellow M, Fowler C. Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1993;  56 245-250
    CrossrefPubMedGoogle Scholar
  • 10 Anderson D W, Ellenberg J H, Leventhal C M. et al . Revised estimate of the prevalence of multiple sclerosis in the United States.  Ann Neurol. 1992;  31 333-336
    CrossrefPubMedGoogle Scholar
  • 11 Nortvedt M W, Riise T, Myhr K M. et al . Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction.  Mult Scler. 2001;  7 231-235
    CrossrefPubMedGoogle Scholar
  • 12 Barak Y, Achiron A, Elizur A. et al . Sexual dysfunction in relapsing-remitting multiple sclerosis: magnetic resonance imaging, clinical and psychological correlates.  J Psychiatry Neurosci. 1996;  21 255-258
    PubMedGoogle Scholar
  • 13 Nortvedt M W, Riise T, Frugard J. et al . Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis.  Mult Scler. 2007;  13 106-112
    CrossrefPubMedGoogle Scholar
  • 14 Hennessey A. Urinary, feaceal and sexual dysfunction in patients with multiple sclerosis.  J Neurol. 1999;  246 1027-1032
    CrossrefPubMedGoogle Scholar
  • 15 Nordenbo A, Anderson J. Disturbances of ano-rectal function in multiple sclerosis.  J Neurol. 1996;  243 445-451
    CrossrefPubMedGoogle Scholar
  • 16 Waldron D, Horgan P, Patel F. et al . Multiple sclerosis: assessment of colonic and anorectal function in the presence of faecal incontinence.  Int J Colorectal Dis. 1993;  8 220-224
    CrossrefPubMedGoogle Scholar
  • 17 Zorzon M, Zivadinov R, Monti Bragadin L. et al . Sexual dysfunction in multiple sclerosis: a 2-year follow-up study.  J Neurol Sci. 2001;  187 1-5
    CrossrefPubMedGoogle Scholar
  • 18 Demirkiran M, Sarica Y, Uguz S. et al . Multiple sclerosis patients with and without sexual dysfunction: are there any differences?.  Mult Scler. 2006;  12 209-214
    CrossrefPubMedGoogle Scholar
  • 19 Zivadinov R, Zorzon M, Locatelli L. et al . Sexual dysfunction in multiple sclerosis: a MRI, neurophysiological and urodynamic study.  J Neurol Sci. 2003;  210 1485-1491
    PubMedGoogle Scholar
  • 20 Rae-Grant A D, Eckert N J, Bartz S. et al . Sensory symptoms of multiple sclerosis: a hidden reservoir o morbidity.  Multi Scler. 1999;  5 179-183
    CrossrefPubMedGoogle Scholar
  • 21 Rubin R. Communication about sexual problems in male patients with multiple sclerosis.  Nurs Stand. 2005;  19 33-37
    PubMedGoogle Scholar
  • 22 Foley F W, LaRocca N G, Sanders A S. et al . Rehabiliation of intimacy and sexual dysfunction in couples with multiple sclerosis.  Mult Scler. 2001;  7 417-421
    CrossrefPubMedGoogle Scholar
  • 23 Sanders A S, Foley F W, LaRocca N G. et al . The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19).  Sex Disabil. 2000;  18 3-26
    CrossrefPubMedGoogle Scholar
  • 24 Zorzon M, Zivadinov R, Bosco A. et al . Sexual dysfunction in multiple sclerosis: a case-control study. I: Frequency and comparison of groups.  Mult Scler. 1999;  5 418-427
    PubMedGoogle Scholar
  • 25 Mattson D, Petrie M, Srivastava D K. et al . Multiple Sclerosis. Sexual dysfunction and its response to medications.  Arch Neurol. 1995;  52 862-868
    CrossrefPubMedGoogle Scholar
  • 26 Ghezzi A, Malvestiti G M, Baldini S. et al . Erectile impotence in multiple sclerosis: a neurophysiological study.  J Neurol. 1995;  242 123-126
    CrossrefPubMedGoogle Scholar
  • 27 Staerman F, Guiraud P, Coeurdacier P. et al . Value of nocturnal penile tumescence and rigidity (NPTR) recording in impotent patients with multiple sclerosis.  Int J Impot Res. 1996;  8 241-245
    PubMedGoogle Scholar
  • 28 NIH . NIH consensus conference: impotence. NIH Consensus development panel on impotence.  JAMA. 1993;  270 83-90
    CrossrefPubMedGoogle Scholar
  • 29 Lizza E F, Rosen R C. Definition and classification of erectile dysfunction. Report of the nomenclature committee of the international society of impotence research.  Int J Impotence Res. 1999;  11 141-143
    CrossrefPubMedGoogle Scholar
  • 30 Teloken C, Rhoden E, Sogari P. et al . Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction.  J Urol. 1998;  159 122-124
    CrossrefPubMedGoogle Scholar
  • 31 Laumann E, Paik A, Rosen R. Sexual dysfunction in the United States: prevalence and predictors.  JAMA. 1999;  281 537-544
    CrossrefPubMedGoogle Scholar
  • 32 Hulter B M, Lundberg P O. Sexual function in women with advanced multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1995;  59 83-86
    CrossrefPubMedGoogle Scholar
  • 33 Yang C C, Bowen J R, Kraft G H. et al . Cortical evoked potentials of the dorsal nerve of the clitoris and female sexual dysfunction in multiple sclerosis.  J Urol. 2000;  164 2010-2013
    CrossrefPubMedGoogle Scholar
  • 34 Rosen R, Brown C, Heiman J. et al . The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.  J Sex Marital Ther. 2000;  26 191-208
    CrossrefPubMedGoogle Scholar
  • 35 Derogatis L R. The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women.  J Sex Marital Ther. 2002;  28 317-330
    CrossrefPubMedGoogle Scholar
  • 36 Sipski M L, Alexander C, Rosen R. Sexual arousal and orgasm in women: effects of spinal cord injury.  Ann Neurol. 2001;  49 35-44
    CrossrefPubMedGoogle Scholar
  • 37 McKenna K E. The neural control of female sexual function.  Neurorehab. 2000;  15 133-143
    PubMedGoogle Scholar
  • 38 Laan E, van Lunsen R, Everaerd W. The effects of tibolone on vaginal blood flow, sexual dysfunction in females with multiple sclerosis and spinal cord involvement.  Int J Impot Res. 2001;  13 30-31
    PubMedGoogle Scholar
  • 39 Caruso S, Intelisano G, Lupo L. et al . Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double-blind, cross-over, placebo-controlles study.  Br J Ostet Gynaecol. 2001;  108 623-628
    CrossrefPubMedGoogle Scholar
  • 40 Brown D A, Kyle J A, Ferrill M J. Assessing the Clinical Efficacy of Sildenafil for the Treatment of Female Sexual Dysfunction.  Ann Pharmacother. 2009;  43 1275-1285
    CrossrefPubMedGoogle Scholar
  • 41 Stöhrer M, Blok B, Castro-Diaz D. et al . EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction.  Eur Urol. 2009;  56 81-88
    CrossrefPubMedGoogle Scholar

Gisa Ellrichmann

Neurologische Klinik, St. Josef Hospital, Ruhr-Universität Bochum

Gudrunstr. 56

44791 Bochum

eMail: gisa.ellrichmann@rub.de