Real-world data on the prevalence and therapy of symptomatic bladder dysfunction in people with multiple sclerosis.

Background: Bladder dysfunctions (BL-D) are common in people with multiple sclerosis (pwMS), significantly affecting daily life, infection risk, and survival. Nonetheless, BL-D are frequently stigmatized and inadequately addressed in clinical practice. To date, no comprehensive analysis of BL-D has been conducted in Germany. Objective: To assess the prevalence of BL-D and its subtypes in a German cohort and identify associated factors and treatment patterns. Methods: Data were analyzed from individuals enrolled in the German MS Register, aged ⩾18 with definite MS. Inclusion required ⩾3 visits and complete data on MS onset, diagnosis date, and BL-D status. BL-D were subclassified into urinary urgency, voiding dysfunction, bladder incontinence, and other BL-D. PwMS with different subtypes were compared regarding clinical, sociodemographic, and therapeutic characteristics and associated factors were identified using logistic regression. Results: The study cohort included 10,572 pwMS (71.7% female) with a mean age of 48.2 years, disease duration of 16.0 years, and median Expanded Disability Status Scale score of 2.0. BL-D was present in 38.0% of pwMS, with urinary urgency being the leading subtype (41.0%). Associations included older age, longer disease duration, progressive disease course, polysymptomatic onset, and receiving disease-modifying therapy. Interestingly, 37.1% of pwMS with BL-D received no bladder treatment, while 36.9% received pharmaceutical and 36.4% non-pharmaceutical bladder treatment. Conclusion: The results highlight the clinical relevance and burden of BL-D in MS and provide first insights into subtype-specific differences in the German MS population. Providing appropriate BL-D care requires investigation into causal factors and a deeper understanding of the underlying reasons of the treatment gap. Design: Retrospective, cross-sectional study.