Urinary Dysfunction Management in Multiple Sclerosis: A Nationwide Real-Life Analysis From the French SNDS Database
Author(s)
Cecile Donze, MD1, Emmanuelle Leray, MD2, Alexandre Vimont, PhD, MSc3, Manon Santrisse, MSc4, Souad Meillassoux, MD5, Camille Roussillon, MSc5, Julien Gautry, MSc5, Emmanuel chartier-kastler, MD6, sandra vukusic, MD7.
1Neurethic Lab – ETHICS EA 7446, Lille, France, 2Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France, 3Senior analyst, Public Health Expertise, paris, France, 4Public Health Expertise, Paris, France, 5Coloplast, Paris, France, 6Sorbonne Université, Academic Hospital Pitié-Salpétrière, AP-HP, paris, France, 7Hospices Civils de Lyon, Department of Neurology, Lyon, France.
1Neurethic Lab – ETHICS EA 7446, Lille, France, 2Rennes University, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, Rennes, France, 3Senior analyst, Public Health Expertise, paris, France, 4Public Health Expertise, Paris, France, 5Coloplast, Paris, France, 6Sorbonne Université, Academic Hospital Pitié-Salpétrière, AP-HP, paris, France, 7Hospices Civils de Lyon, Department of Neurology, Lyon, France.
OBJECTIVES: Urinary dysfunction (UD) is a common comorbidity in people with multiple sclerosis (PwMS), negatively affecting quality of life and increasing the risk of complications when insufficiently diagnosed or managed. The objective was to quantify and describe the management of UD (UDM) in the French MS population using nationwide real-life data.
METHODS: PwMS were identified in the French National Health Data System (SNDS) if they were alive in 2022 and had, between 2005 and 2020, either a long-term disease status for MS, MS-related hospitalizations, or reimbursements for MS-specific treatments. Follow-up continued until 2022. UDM was assessed based on data regarding diagnostic procedures, pharmacological treatments, use of medical devices, surgeries, and UD-related hospitalizations. UDM was categorized into urological assessments, non-invasive treatments, invasive treatments, and surgical interventions.
RESULTS: A total of 127,987 PwMS were included (72% women; mean age 53 years). In 2022, 16.3% underwent urological assessments (14.4% ultrasound; 4.4% urodynamic testing), 5.5% were hospitalized for UD, and 25.2% received urological treatments. Non-invasive treatments were used in 22% (12.5% antimuscarinics; 8.5% alpha-blockers; 3% electrostimulation), while 8.5% received invasive treatments (6.5% intermittent catheterization; 2.3% indwelling catheters; 1.4% botulinum toxin), and 1.1% underwent surgery. The proportion of PwMS receiving annual UDM increased with disease duration, from 35% at the time of MS identification to 50% after 25 years. Between 2013 and 2022, 59% had at least one diagnostic procedure and 41% of them received no treatment. During 2021-2022, 43% received UDM at least once, but only 34% annually.
CONCLUSIONS: Despite the frequent occurrence of UD in PwMS, only a minority received treatment. The gap between annual and biennial UDM rates suggests discontinuity of care and unmet needs. The lack of clinical data on symptom severity and disability underscores the need for further investigation. Enhancing awareness among patients and healthcare providers is essential to improve urinary care in MS.
METHODS: PwMS were identified in the French National Health Data System (SNDS) if they were alive in 2022 and had, between 2005 and 2020, either a long-term disease status for MS, MS-related hospitalizations, or reimbursements for MS-specific treatments. Follow-up continued until 2022. UDM was assessed based on data regarding diagnostic procedures, pharmacological treatments, use of medical devices, surgeries, and UD-related hospitalizations. UDM was categorized into urological assessments, non-invasive treatments, invasive treatments, and surgical interventions.
RESULTS: A total of 127,987 PwMS were included (72% women; mean age 53 years). In 2022, 16.3% underwent urological assessments (14.4% ultrasound; 4.4% urodynamic testing), 5.5% were hospitalized for UD, and 25.2% received urological treatments. Non-invasive treatments were used in 22% (12.5% antimuscarinics; 8.5% alpha-blockers; 3% electrostimulation), while 8.5% received invasive treatments (6.5% intermittent catheterization; 2.3% indwelling catheters; 1.4% botulinum toxin), and 1.1% underwent surgery. The proportion of PwMS receiving annual UDM increased with disease duration, from 35% at the time of MS identification to 50% after 25 years. Between 2013 and 2022, 59% had at least one diagnostic procedure and 41% of them received no treatment. During 2021-2022, 43% received UDM at least once, but only 34% annually.
CONCLUSIONS: Despite the frequent occurrence of UD in PwMS, only a minority received treatment. The gap between annual and biennial UDM rates suggests discontinuity of care and unmet needs. The lack of clinical data on symptom severity and disability underscores the need for further investigation. Enhancing awareness among patients and healthcare providers is essential to improve urinary care in MS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH275
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Neurological Disorders, Urinary/Kidney Disorders