This group of clinicians raises important points about the subjectiveness of bladder symptoms in multiple sclerosis and their need for confirmation with urodynamic testing. The studies included in our systematic review did not clearly define the variable, sphincter symptoms, and because many of the studies collected information about symptoms at onset retrospectively, it is likely that this variable represents significant, subjective sphincter symptoms as patients with milder symptoms would be more likely to forget them (recall bias). Future studies should clearly define variables to aid interpretation of findings.
Langer-Gould A. Spinchter Symptoms as Predictors of Long-term Disability in Multiple Sclerosis—Reply. Arch Neurol. 2007;64(9):1359. doi:10.1001/archneur.64.9.1359-b