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Botulinum neurotoxin-A treatment of lower urinary tract symptoms in multiple sclerosis.

Multiple sclerosis (MS) is the most common neuroinflammatory disease of the central nervous system and a leading cause of disability in young adults. Symptoms related to vesicourethral dysfunction are very prevalent, but not specific to underlying urodynamic abnormalities. Detrusor overactivity and detrusor external sphincter dysynergia are the most frequent findings and are usually linked. Botulinum neurotoxin-A injection represents a significant advance in the management of voiding dysfunction among MS patients failing first-line therapy. It significantly improves patients' urodynamic parameters and quality of life, with efficacy sustained by repeated injections and minimal risk of adverse events.