Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study

被引:10
作者
Eschlbock, Sabine [1 ]
Kiss, Gustav [2 ]
Krismer, Florian [1 ]
Fanciulli, Alessandra [1 ]
Kaindlstorfer, Christine [1 ]
Raccagni, Cecilia [1 ,3 ,4 ]
Seppi, Klaus [1 ]
Kiechl, Stefan [1 ]
Panicker, Jalesh N. [5 ]
Wenning, Gregor K. [1 ]
机构
[1] Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria
[2] Med Univ Innsbruck, Dept Urol, Div Neurourol, Innsbruck, Austria
[3] Reg Gen Hosp, Dept Neurol, Bolzano, Italy
[4] Natl Hosp Neurol & Neurosurg, Dept Uroneurol, London, England
[5] UCL Queen Sq Inst Neurol, London, England
来源
MOVEMENT DISORDERS CLINICAL PRACTICE | 2021年 / 8卷 / 07期
关键词
multiple system atrophy; urodynamic evaluation; urologic features; autonomic failure; PARKINSONS-DISEASE; URINARY DYSFUNCTION; ORTHOSTATIC HYPOTENSION; BLADDER DYSFUNCTION; NATURAL-HISTORY; SYMPTOMS; CONTRACTILITY; INCONTINENCE; OBSTRUCTION; DIAGNOSIS;
D O I
10.1002/mdc3.13307
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Urological dysfunction in patients with multiple system atrophy (MSA) is one of the main manifestations of autonomic failure. Urodynamic examination is clinically relevant since underlying pathophysiology of lower urinary tract (LUT) dysfunction can be variable. Objective Evaluation of the pathophysiology of urological symptoms and exploration of differences in urodynamic patterns of LUT dysfunction between MSA-P and MSA-C. Methods Retrospective study of patients with possible and probable MSA who were referred for urodynamic studies between 2004 and 2019. Demographic data, medical history, physical examination and urodynamic studies assessing storage and voiding dysfunction were obtained. Results Seventy-four patients were included in this study (MSA-P 64.9% n = 48; median age 62.5 (IQR 56.8-70) years). Detrusor overactivity during filling phase was noted in 58.1% (n = 43) of the patients. In the voiding phase, detrusor sphincter dyssynergia and detrusor underactivity were observed in 24.6% (n = 17) and in 62.1% (n = 41) of the patients, respectively. A postmicturition residual volume of over 100 ml was present in 71.4% (n = 50) of the patients. Comparison of MSA subtypes showed weaker detrusor contractility in MSA-P compared to MSA-C [pdetQmax 26.2 vs. 34.4 cmH20, P = 0.04]. In 56.2% (n = 41) of patients pathophysiology of LUT dysfunction was deemed to be neurogenic and consistent with the diagnosis of MSA. In 35.6% (n = 26) urodynamic pattern suggested other urological co-morbidities. Conclusion Urodynamic evaluation is an important tool to analyze the pattern of LUT dysfunction in MSA. Impaired detrusor contractility was seen more in MSA-P which needs to be investigated in further studies.
引用
收藏
页码:1052 / 1060
页数:9
相关论文
共 45 条
  • [11] An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD)
    Gajewski, Jerzy B.
    Schurch, Brigitte
    Hamid, Rizwan
    Averbeck, Marcio
    Sakakibara, Ryuji
    Agro, Enrico F.
    Dickinson, Tamara
    Payne, Christopher K.
    Drake, Marcus J.
    Haylen, Bernie T.
    [J]. NEUROUROLOGY AND URODYNAMICS, 2018, 37 (03) : 1152 - 1161
  • [12] Second consensus statement on the diagnosis of multiple system atrophy
    Gilman, S.
    Wenning, G. K.
    Low, P. A.
    Brooks, D. J.
    Mathias, C. J.
    Trojanowski, J. Q.
    Wood, N. W.
    Colosimo, C.
    Duerr, A.
    Fowler, C. J.
    Kaufmann, H.
    Klockgether, T.
    Lees, A.
    Poewe, W.
    Quinn, N.
    Revesz, T.
    Robertson, D.
    Sandroni, P.
    Seppi, K.
    Vidailhet, M.
    [J]. NEUROLOGY, 2008, 71 (09) : 670 - 676
  • [13] PARKINSONISM - ONSET PROGRESSION AND MORTALITY
    HOEHN, MM
    YAHR, MD
    [J]. NEUROLOGY, 1967, 17 (05) : 427 - &
  • [14] Incomplete emptying and urinary retention in multiple-system atrophy: When does it occur and how do we manage it?
    Ito, Takashi
    Sakakibara, Ryuji
    Yasuda, Kosaku
    Yamamoto, Tatsuya
    Uchiyama, Tomoyuki
    Liu, Zhi
    Yamanishi, Tomonori
    Awa, Yusuke
    Yamamoto, Kaori
    Hattori, Takamichi
    [J]. MOVEMENT DISORDERS, 2006, 21 (06) : 816 - 823
  • [15] Premotor signs and symptoms of multiple system atrophy
    Jecmenica-Lukic, Milica
    Poewe, Werner
    Tolosa, Eduardo
    Wenning, Gregor K.
    [J]. LANCET NEUROLOGY, 2012, 11 (04) : 361 - 368
  • [16] Neurogenic bladder in progressive supranuclear palsy: A comparison with Parkinson's disease and multiple system atrophy
    Kim, Kyeong Joon
    Jeong, Seong Jin
    Kim, Jong-Min
    [J]. NEUROUROLOGY AND URODYNAMICS, 2018, 37 (05) : 1724 - 1730
  • [17] Impaired detrusor contractility is the pathognomonic urodynamic finding of multiple system atrophy compared to idiopathic Parkinson's disease
    Kim, Myong
    Jung, Jae Hyun
    Park, Juhyun
    Son, Hwancheol
    Jeong, Seong Jin
    Oh, Seung-June
    Cho, Sung Yong
    [J]. PARKINSONISM & RELATED DISORDERS, 2015, 21 (03) : 205 - 210
  • [18] Erectile and urinary dysfunction may be the presenting features in patients with multiple system atrophy: a retrospective study
    Kirchhof, K
    Apostolidis, AN
    Mathias, CJ
    Fowler, CJ
    [J]. INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 2003, 15 (04) : 293 - 298
  • [19] Natural history of multiple system atrophy in the USA: a prospective cohort study
    Low, Phillip A.
    Reich, Stephen G.
    Jankovic, Joseph
    Shults, Clifford W.
    Stern, Matthew B.
    Novak, Peter
    Tanner, Caroline M.
    Gilman, Sid
    Marshall, Frederick J.
    Wooten, Frederick
    Racette, Brad
    Chelimsky, Thomas
    Singer, Wolfgang
    Sletten, David M.
    Sandroni, Paola
    Mandrekar, Jay
    [J]. LANCET NEUROLOGY, 2015, 14 (07) : 710 - 719
  • [20] Lower urinary tract symptoms of neurological origin in urological practice
    Magari, Tomohiro
    Fukabori, Yoshitatsu
    Ogura, Haruyuki
    Suzuki, Kazuhiro
    [J]. CLINICAL AUTONOMIC RESEARCH, 2013, 23 (02) : 67 - 72