Time to be Ready to Void: A new tool to assess the time needed to perform micturition for patients with multiple sclerosis

Background: Urgency urinary incontinence is one of the major disabling urinary symptoms in people with multiple sclerosis (PwMS). The warning time (time from first sensation of urgency to voiding or incontinence) only partially reflects the possibility of continence. Other factors such as mobility, difficulties in transfer or undressing can influence this time. Objectives: The aim was to create a specific test for PwMS to assess the global time required to be ready to perform micturition and to assess its reliability. Methods: The Time to be Ready to Void (TRV) was based on 2 timed steps: "mobility" stage, including standing up and walking 6 m to the toilet, and the "settled" stage, starting as soon as the individual opens the toilet door until readiness for micturition. All participants performed the TRV twice. Reliability were assessed by the intraclass correlation coefficient (ICC) and convergent validity by Spearman correlation coefficient. Results: We included 71 PwMS (mean [SD] age 54.4 [11.7] years). Inter-rater reliability was excellent for the TRV mobility stage (ICC: 0.97), settled stage (ICC: 0.99) and total test (ICC: 0.99). Test-retest reliability was good for the mobility stage (ICC: 0.88) and total test (ICC: 0.81) and moderate for the settled stage (ICC: 0.67). Test-retest reliability assessed by a Likert-type scale was good for each stage (kappa 0.75 and 0.88). The mobility stage was correlated with the scores for the Timed Up and Go test, 10-Meter Walk Test, and Tinetti Mobility Test (rho = 0.89; rho = 0.88; rho = -0.67, respectively; P < 0.0001) and the settled stage with scores for the Tinetti Mobility Test, Functional Independence Measure and Nine Hold Peg test (right) (rho = -0.48; rho = -0.36; rho = 0.31, respectively; P < 0.01). Comprehension, acceptance and relevance were rated good by most participants (97%, 95% and 90%, respectively). Conclusion: The TRV is a new tool to measure the global time needed to be ready to achieve micturition in PwMS. It seems useful in clinical practice for overactive bladder in addition to the classical warning time because it takes into account all the time needed to accomplish micturition (mobility, undressing, installation). (C) 2020 Elsevier Masson SAS. All rights reserved.