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
Further Information

Publication History

Publication Date:
14 December 2009 (online)

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.

Literatur

  • 1 Henze T, Pette M, Rieckmann P. Symptomatische Therapie der Multiplen Sklerose. Aktuelle Therapieempfehlungen Multiple Sklerose Therapie Konsensus Gruppe (MSTKG). August 2004
  • 2 Kurtzke J F. A new scale for evaluating disability in multiple sclerosis.  Neurology. 1955;  5 580-583
  • 3 Kurztke J F. Rating neurological impairment in multiple sclerosis: an expended disability status scale (EDSS).  Neurology. 1983;  33 1444-1452
  • 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
  • 5 Kurtzke J F. A proposal for a uniform minimal record of disability in multiple sclerosis.  Acta Neurol Scand. 1981;  64 110-129
  • 6 International Federation of Multiple Sclerosis .Minimal Record of Disability for Multiple Sclerosis, National Multiple Sclerosis Society of the United States. New York; 1985
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 14 Hennessey A. Urinary, feaceal and sexual dysfunction in patients with multiple sclerosis.  J Neurol. 1999;  246 1027-1032
  • 15 Nordenbo A, Anderson J. Disturbances of ano-rectal function in multiple sclerosis.  J Neurol. 1996;  243 445-451
  • 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
  • 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
  • 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
  • 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
  • 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
  • 21 Rubin R. Communication about sexual problems in male patients with multiple sclerosis.  Nurs Stand. 2005;  19 33-37
  • 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
  • 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
  • 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
  • 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
  • 26 Ghezzi A, Malvestiti G M, Baldini S. et al . Erectile impotence in multiple sclerosis: a neurophysiological study.  J Neurol. 1995;  242 123-126
  • 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
  • 28 NIH . NIH consensus conference: impotence. NIH Consensus development panel on impotence.  JAMA. 1993;  270 83-90
  • 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
  • 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
  • 31 Laumann E, Paik A, Rosen R. Sexual dysfunction in the United States: prevalence and predictors.  JAMA. 1999;  281 537-544
  • 32 Hulter B M, Lundberg P O. Sexual function in women with advanced multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1995;  59 83-86
  • 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
  • 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
  • 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
  • 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
  • 37 McKenna K E. The neural control of female sexual function.  Neurorehab. 2000;  15 133-143
  • 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
  • 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
  • 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
  • 41 Stöhrer M, Blok B, Castro-Diaz D. et al . EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction.  Eur Urol. 2009;  56 81-88

Gisa Ellrichmann

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

Gudrunstr. 56

44791 Bochum

Email: gisa.ellrichmann@rub.de