Guidelines for Dia­gnosis and Treatment of Lower Urinary Tract Symp­toms in Patients with Multiple Sclerosis in the Czech Republic –  Interdisciplinary Expert Consensus Us­ing DELPHI Methodology

Authors: J. Krhut 1,2;  O. Zapletalová 3;  R. Zachoval 4–6;  E. Meluzínová 7;  L. Zámečník 8;  M. Vachová 9;  E. Houžvičková 7;  G. Varga 10
Authors‘ workplace: Urologické oddělení, FN Ostrava 1;  Urologická klinika LF MU a FN Brno 10;  Katedra chirurgických oborů, LF OU v Ostravě 2;  Neurologická klinika LF OU a FN Ostrava 3;  Urologické oddělení, Thomayerova nemocnice, Praha 4;  Urologická klinika 1. LF UK Praha 5;  Urologická klinika 3. LF UK Praha 6;  Neurologická klinika 2. LF UK a FN Motol, Praha 7;  Urologická klinika 1. LF UK a VFN v Praze 8;  Neurologické oddělení, Nemocnice Teplice, o. z., Krajská zdravotní, a. s. 9
Published in: Cesk Slov Neurol N 2017; 80/113(2): 233-236
doi: 10.14735/amcsnn2017233


Lower urinary tract symptoms are prevalent in approximately 75% of patients suffering from multiple sclerosis (MS) and have significant impact on their quality of life. There is a lack of evidence in many aspects of diagnostics and treatment of lower urinary tract symptoms in MS patients. The aim of the study was to provide guidelines for urologic diagnostics and treatment based on expert opinion in clinical practice in the Czech Republic.

Material and methods:
The guidelines were created using the DELPHI methodology. Comprehensive literature search according to PRISMA statement was performed. Based on this search, the first version of the guidelines was formulated. Members of a panel of experts rated individual items of the guidelines using a 9-point Lickert scale, where 1 means „strong disagreement“ and 9 means „strong agreement“. Subsequently, statistical analysis was performed. All items with rating median of less than 6 were updated. The second version of the guidelines was evaluated using the same technique.

In total, two rounds of communication were held. The second version of the guidelines was considered final due to high degree of consensus. Compared to the original version, 14 of 58 items were modified during the communication process. Average rating medians of the items included in the final version was 8.22.

Interdisciplinary consensus was reached using the DELPHI methodology. Resulting guidelines should be used by both urologist and neurologist in routine clinical practice.

Key words:
multiple sclerosis – lower urinary tract symptoms – urinary incontinence – DELPHI

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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