Lower urinary tract dysfunction in patients with dysautonomia. Clin Auton Res 2015 Dec;25(6):407-10
Date
11/05/2015Pubmed ID
26530163DOI
10.1007/s10286-015-0320-zScopus ID
2-s2.0-84948717591 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
OBJECTIVE: With the goal of better defining the types of bladder dysfunction observed in this population, we present the chief urologic complaints, results of urodynamic studies, and treatments of patients with dysautonomia-related urinary symptoms.
METHODS: All patients with dysautonomia referred to our neurourology clinic between 2005 and 2015 for management of lower urinary tract dysfunction were retrospectively reviewed. Each patient's chief urologic complaint was recorded and used to initially characterize the bladder storage or voiding symptoms. Patient evaluation included history and physical examination, urinalysis, post void bladder ultrasound, and urodynamic studies. Successful treatment modalities that subjectively or objectively improved symptoms were recorded.
RESULTS: Of 815 patients with the diagnosis of dysautonomia, 82 (10 %) were referred for evaluation of lower urinary tract dysfunction. Mean age was 47 years (range 12-83) and 84 % were female. The chief complaint was urinary urgency ± incontinence in 61 % and hesitancy in 23 % of patients. Urodynamic findings demonstrated detrusor overactivity ± incontinence in 50 % of patients, although chief complaint did not reliably predict objective findings. Successful objective and subjective treatments were multimodal and typically non-operative.
INTERPRETATION: Lower urinary tract dysfunction may develop in at least 10 % of patients with dysautonomia, predominantly females. Bladder storage or voiding complaints do not reliably predict urodynamic findings. Urodynamically, most patients exhibited detrusor overactivity. The majority of patients were successfully managed with medical or physical therapy.
Author List
Aubin MS, Shridharani A, Barboi AC, Guralnick ML, Jaradeh SS, Prieto TE, O'Connor RCAuthors
Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of WisconsinRobert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Child
Female
Humans
Male
Middle Aged
Primary Dysautonomias
Retrospective Studies
Urinary Tract
Urination Disorders
Urologic Diseases
Young Adult
