{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:11:46Z","timestamp":1785247906113,"version":"3.55.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bladder dysfunctions (BL-D) are common in people with multiple sclerosis (pwMS), significantly affecting daily life, infection risk, and survival. Nonetheless, BL-D are frequently stigmatized and inadequately addressed in clinical practice. To date, no comprehensive analysis of BL-D has been conducted in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the prevalence of BL-D and its subtypes in a German cohort and identify associated factors and treatment patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were analyzed from individuals enrolled in the German MS Register, aged \u2a7e18 with definite MS. Inclusion required \u2a7e3 visits and complete data on MS onset, diagnosis date, and BL-D status. BL-D were subclassified into urinary urgency, voiding dysfunction, bladder incontinence, and other BL-D. PwMS with different subtypes were compared regarding clinical, sociodemographic, and therapeutic characteristics and associated factors were identified using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study cohort included 10,572 pwMS (71.7% female) with a mean age of 48.2\u2009years, disease duration of 16.0\u2009years, and median Expanded Disability Status Scale score of 2.0. BL-D was present in 38.0% of pwMS, with urinary urgency being the leading subtype (41.0%). Associations included older age, longer disease duration, progressive disease course, polysymptomatic onset, and receiving disease-modifying therapy. Interestingly, 37.1% of pwMS with BL-D received no bladder treatment, while 36.9% received pharmaceutical and 36.4% non-pharmaceutical bladder treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results highlight the clinical relevance and burden of BL-D in MS and provide first insights into subtype-specific differences in the German MS population. Providing appropriate BL-D care requires investigation into causal factors and a deeper understanding of the underlying reasons of the treatment gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective, cross-sectional study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864261456559","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T09:07:23Z","timestamp":1784970443000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world data on the prevalence and therapy of symptomatic bladder dysfunction in people with multiple sclerosis"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8750-7048","authenticated-orcid":false,"given":"Mathia","family":"Kirstein","sequence":"first","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Krausenstr. 50, 30171 Hannover, Germany"},{"name":"Division of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-774X","authenticated-orcid":false,"given":"Niklas","family":"Frahm","sequence":"additional","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Hannover, Germany"},{"name":"Division of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ellenberger","sequence":"additional","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Stahmann","sequence":"additional","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Fneish","sequence":"additional","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Peters","sequence":"additional","affiliation":[{"name":"German MS Register, MS Forschungs- und Projektentwicklungs-gGmbH (MS Research and Project Development gGmbH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[{"name":"Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Warnke","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Gie\u00dfen and Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef Hospital, Ruhr University, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Flachenecker","sequence":"additional","affiliation":[{"name":"Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Berger","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Social Medicine, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Mai","sequence":"additional","affiliation":[{"name":"Deutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. 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