Researchers combined results from 22 studies involving 39,304 people with multiple sclerosis to estimate how often neurogenic bladder occurs. Neurogenic bladder refers to bladder difficulties linked to changes in nervous-system control, including problems storing or emptying urine.
Health & Medicine1 week ago
Review finds bladder problems in about half of people with multiple sclerosis
The pooled estimate included storage, emptying, and mixed bladder symptoms, but study methods produced widely varying results.
High evidenceReviewSome caution advised
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
What the review covered
The researchers conducted a systematic review and meta-analysis of prevalence studies involving people with multiple sclerosis. They searched MEDLINE, Embase, Scopus, and Google Scholar; included 22 studies with a combined total of 39,304 participants; assessed risk of bias with the ROBINS-E scale; and used statistical methods including subgroup analysis, meta-regression, sensitivity analysis, and prediction intervals. The paper also proposed an evaluation algorithm, but the abstract does not provide enough detail to assess or validate that algorithm.
What the evidence shows
Across the included human studies, the pooled prevalence of neurogenic bladder was 48.8% (95% confidence interval, 34.1% to 63.7%). The pooled estimates were 39.1% for storage symptoms, 21.4% for voiding symptoms, and 40.9% for mixed symptoms. Reported prevalence in individual studies ranged from 6% to 94%. Meta-regression did not find significant associations between prevalence and age, disability measured by the Expanded Disability Status Scale, or disease duration. Sensitivity and subgroup analyses indicated that differences in definitions, assessment instruments, and study design accounted for much of the variation.
Where this may apply
These findings may apply to people with multiple sclerosis who are similar to those included in the 22 underlying studies. They do not establish the prevalence for every person with multiple sclerosis or for people without the condition, and they do not by themselves show that any particular evaluation approach improves outcomes.
The significance
The findings suggest that bladder symptoms are commonly reported or identified among people with multiple sclerosis, while also showing that the estimated frequency depends heavily on how symptoms are defined and measured. This supports the researchers' emphasis on more consistent assessment methods, but the review does not test whether the proposed algorithm or any specific care pathway improves health outcomes. The findings describe prevalence in study populations and are not evidence of a causal relationship or a treatment effect.
Limitations & evidence assessment
The estimates varied widely, from 6% to 94%, and statistical heterogeneity was very high. The researchers attributed most of this variation to differences in diagnostic definitions, assessment instruments, and study design rather than to age, disability score, or disease duration. The abstract does not provide enough information to judge the detailed quality or representativeness of every included study, although risk of bias was assessed. As a review of existing studies, the analysis estimates prevalence but cannot show that multiple sclerosis or any other factor caused the bladder symptoms, and the proposed evaluation algorithm was not reported here as having been tested for improved patient outcomes.
Why this evidence level: Meta-analysis pooling multiple studies sits at the top of common evidence hierarchies.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
Neurological Sciences · 2026 · DOI: 10.1007/s10072-026-09289-6
Authors: Vasileios Giannopapas, Evangelia M. Dimitriadou, Dimitrios K. Kitsos, Alexandra Akrivaki, Maria‐Ioanna Stefanou, Konstantina Stavrogianni, Athanasios K. Chasiotis, John S. Tzartos, Daphne Bakalidou, Georgios Tsivgoulis, Georgios P. Paraskevas, Konstantinos Tsamis, Sotirios Giannopoulos
Institutions: University of Ioannina, National and Kapodistrian University of Athens, University of West Attica
