[Multiple sclerosis and urolithiasis]

Objective: The aim of our study was to determine the nature of urinary stones and the main lithogenic process in patients with multiple sclerosis who developed secondary urolithiasis.

Patients and method: This is a retrospective study of 60 urinary stones from 49 patients with lithiasis including 30 women and 19 men. The stones have been analyzed by optical microscopy and infrared spectroscopy.

Results: Our study clearly showed the net preponderance of phosphatic stones. Urinary stones were mainly located in the upper urinary tract (2/3 of cases). A particularly high frequency of struvite was observed among these stones (65% of cases in women and 45% of cases in men), thus suggesting the main lithogenic mechanism in multiple sclerosis patients was a urinary tract infection by urea splitting-bacteria. The second lithogenic process among these patients was metabolic. The high frequency of weddellite and brushite, especially in men, suggested that mainly hypercalciuria was involved in these metabolic stones.

Conclusion: Urolithiasis in multiple sclerosis was mainly due to urinary tract infection, especially in women. Urinary tract infection related to bladder and sphincter disorders is extremely frequent and polymorphic in multiple sclerosis. Hence the importance of providing appropriate care to prevent complications of urinary tract infections and, especially, the ascending migration of microorganisms and the risk of pyelonephritis and of infectious kidney stones.