Prevalence of urinary symptoms and positive urine culture stratified by the degree of neurologic impairment. The gray bars represent the prevalence of urinary symptoms; the white bars, the prevalence of positive urine cultures; and the black bars, the percentage of urinary symptoms that may have been explained by a positive urine culture. Of the 80 patients without neurologic impairment (EDSS = 0.0), 22 (27.5%) had urinary symptoms and 05 (6.3%) had positive urine culture. Of the 42 patients with incipient myelopathy (EDSS 1.0–3.0), 16 (38.1%) had urinary symptoms and 04 (9.5%) had positive urine culture. Of the 33 patients with HAM/TSP (EDSS = 3.0), 24 (72.7%) had urinary symptoms and 07 (21.2%) had positive urine culture. A positive urine culture may explain the urinary symptomatology in 23% (5/22), 25% (4/16), and 29% (7/24) of patients without neurologic involvement, incipient myelopathy, and HAM/TSP, respectively.