Editorial

The bladder in multiple sclerosis1 Bladder dysfunction is present in 80WO of patients with multiple sclerosis (MS) although it is rare for such patients to present with urinary symptoms as the first manifestation of the disease (Miller et al. 1965). The Newcastle team found that only 2 % of cases first presented with urinary problems. Patients present with sexual symptoms and urgency as an early sign of the disorder. In most patients with MS the urinary incontinence may be socially crippling especially in a relatively young, mobile and active individual. It is therefore important to get the patient 'home and dry'. With the advent of urodynamic investigations it was hoped that the study of vesico-urethral dysfunction in such patients would provide clear-cut information which would be of value in their management. It had been assumed that the symptoms would correlate with the findings, so that a simple classification of the pathophysiology would enable treatment planning to be straight-forward. Such optimism has not been fulfilled. Many have found the interpretation of data difficult and there is a lack of correlation between symptoms and pressure studies, between the bladder and sphincter measurements (Anderson &amp