Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?
Identifieur interne : 000056 ( Istex/Corpus ); précédent : 000055; suivant : 000057Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?
Auteurs : Takashi Ito ; Ryuji Sakakibara ; Kosaku Yasuda ; Tatsuya Yamamoto ; Tomoyuki Uchiyama ; Zhi Liu ; Tomonori Yamanishi ; Yusuke Awa ; Kaori Yamamoto ; Takamichi HattoriSource :
- Movement Disorders [ 0885-3185 ] ; 2006-06-06.
English descriptors
- KwdEn :
Abstract
Neurogenic urinary retention can be a major cause of morbidity in multiple‐system atrophy (MSA). However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0–760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor–sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self‐catheterization (CISC) was introduced in most patients. Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra‐oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short‐term efficacy and potential adverse effects of these alternatives is mandatory. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.20815
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ISTEX:3444BDF50F9C3BD17B42D0CC5601D168CB7AD44ALe document en format XML
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Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. 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However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0–760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor–sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self‐catheterization (CISC) was introduced in most patients. Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra‐oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short‐term efficacy and potential adverse effects of these alternatives is mandatory. © 2006 Movement Disorder Society</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1712</abstractCharCount><pdfWordCount>5312</pdfWordCount><pdfCharCount>34038</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>251</abstractWordCount></qualityIndicators><title>Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?</title><genre><json:string>Serial article</json:string></genre><host><volume>21</volume><pages><total>8</total><last>823</last><first>816</first></pages><issn><json:string>0885-3185</json:string></issn><issue>6</issue><subject><json:item><value>Research 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type="first">Ryuji</forename><surname>Sakakibara</surname><roleName type="degree">MD, PhD</roleName></persName><note type="correspondence"><p>Correspondence: Neurology Department, Chiba University, 1‐8‐1 Inohana Chuo‐ku, Chiba 260‐8670, Japan</p></note><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation></author><author><persName><forename type="first">Kosaku</forename><surname>Yasuda</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Department of Urology, Koshigaya Hospital, Dokkyo Medical College, Tochigi, Japan</affiliation></author><author><persName><forename type="first">Tatsuya</forename><surname>Yamamoto</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation></author><author><persName><forename type="first">Tomoyuki</forename><surname>Uchiyama</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Department of Neurology, 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However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0–760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor–sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self‐catheterization (CISC) was introduced in most patients. Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra‐oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short‐term efficacy and potential adverse effects of these alternatives is mandatory. © 2006 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>multiple‐system atrophy</term></item><item><term>urinary retention</term></item><item><term>clean intermittent self‐catheterization</term></item><item><term>α‐adrenergic antagonists</term></item><item><term>transurethral sphincterotomy</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-06-08">Received</change><change when="2005-09-13">Registration</change><change when="2006-06-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/3444BDF50F9C3BD17B42D0CC5601D168CB7AD44A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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type="figureTotal" number="3"></count><count type="tableTotal" number="0"></count><count type="referenceTotal" number="49"></count><count type="wordTotal" number="5824"></count></countGroup><titleGroup><title type="main" xml:lang="en">Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?</title><title type="short" xml:lang="en">Incomplete Emptying and Urinary Retention</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Takashi</givenNames><familyName>Ito</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Ryuji</givenNames><familyName>Sakakibara</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email normalForm="sakakibara@faculty.chiba-u.jp">sakakibara@faculty.chiba‐u.jp</email></contactDetails></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Kosaku</givenNames><familyName>Yasuda</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Tatsuya</givenNames><familyName>Yamamoto</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Tomoyuki</givenNames><familyName>Uchiyama</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Zhi</givenNames><familyName>Liu</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Tomonori</givenNames><familyName>Yamanishi</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Yusuke</givenNames><familyName>Awa</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Kaori</givenNames><familyName>Yamamoto</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Takamichi</givenNames><familyName>Hattori</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="JP" type="organization"><unparsedAffiliation>Department of Neurology, Chiba University, Chiba, Japan</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="JP" type="organization"><unparsedAffiliation>Department of Urology, Koshigaya Hospital, Dokkyo Medical College, Tochigi, Japan</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="JP" type="organization"><unparsedAffiliation>Department of Urology, Dokkyo Medical College, Tochigi, Japan</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="JP" type="organization"><unparsedAffiliation>Department of Urology, Chiba University, Chiba, Japan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">multiple‐system atrophy</keyword><keyword xml:id="kwd2">urinary retention</keyword><keyword xml:id="kwd3">clean intermittent self‐catheterization</keyword><keyword xml:id="kwd4">α‐adrenergic antagonists</keyword><keyword xml:id="kwd5">transurethral sphincterotomy</keyword></keywordGroup><fundingInfo><fundingAgency>U.S. National Organization of Rare Disorders</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Neurogenic urinary retention can be a major cause of morbidity in multiple‐system atrophy (MSA). However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0–760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor–sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self‐catheterization (CISC) was introduced in most patients. Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra‐oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short‐term efficacy and potential adverse effects of these alternatives is mandatory. © 2006 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Incomplete Emptying and Urinary Retention</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?</title></titleInfo><name type="personal"><namePart type="given">Takashi</namePart><namePart type="family">Ito</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ryuji</namePart><namePart type="family">Sakakibara</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><description>Correspondence: Neurology Department, Chiba University, 1‐8‐1 Inohana Chuo‐ku, Chiba 260‐8670, Japan</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kosaku</namePart><namePart type="family">Yasuda</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Urology, Koshigaya Hospital, Dokkyo Medical College, Tochigi, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tatsuya</namePart><namePart type="family">Yamamoto</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tomoyuki</namePart><namePart type="family">Uchiyama</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zhi</namePart><namePart type="family">Liu</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tomonori</namePart><namePart type="family">Yamanishi</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Urology, Dokkyo Medical College, Tochigi, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yusuke</namePart><namePart type="family">Awa</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Urology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kaori</namePart><namePart type="family">Yamamoto</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Urology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Takamichi</namePart><namePart type="family">Hattori</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Chiba University, Chiba, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-06-06</dateIssued><dateCaptured encoding="w3cdtf">2005-06-08</dateCaptured><dateValid encoding="w3cdtf">2005-09-13</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="references">49</extent><extent unit="words">5824</extent></physicalDescription><abstract lang="en">Neurogenic urinary retention can be a major cause of morbidity in multiple‐system atrophy (MSA). However, the timing of its appearance has not been entirely clear, and neither have the medical and surgical modalities for managing patients. We present the data obtained from our uroneurological assessment and therapeutic interventions at various stages of MSA. We recruited 245 patients with probable MSA. We measured postvoid residuals (PVR) and performed EMG cystometry in all patients. The grand average volume of PVR was 140 mL (range, 0–760) in our patients. The average PVR volume was 71 mL in the first year, increasing to 129 mL in the second year and 170 mL by the fifth year. The percentages of patients with complete urinary retention, acontractile detrusor, and detrusor–sphincter dyssynergia (DSD) also increased. The increase in PVR resulted in a decrease in functional bladder capacity, together with an increase in detrusor overactivity and neurogenic sphincter EMG. Clean intermittent self‐catheterization (CISC) was introduced in most patients. Bladder‐oriented therapy (cholinergic agents) had a limited value, whereas urethra‐oriented therapy benefited patients with DSD (surgery) for up to 2 years, but syncope occurred in a subset of patients (α‐blockers). MSA patients present with large PVR by the second year of illness, and that large PVR secondarily causes urinary frequency. CISC is the recommended treatment for most patients. Urethra‐oriented medication and surgery benefit patients who would have difficulty performing CISC, although careful consideration of the short‐term efficacy and potential adverse effects of these alternatives is mandatory. © 2006 Movement Disorder Society</abstract><note type="funding">U.S. National Organization of Rare Disorders</note><subject lang="en"><genre>Keywords</genre><topic>multiple‐system atrophy</topic><topic>urinary retention</topic><topic>clean intermittent self‐catheterization</topic><topic>α‐adrenergic antagonists</topic><topic>transurethral sphincterotomy</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>816</start><end>823</end><total>8</total></extent></part></relatedItem><identifier type="istex">3444BDF50F9C3BD17B42D0CC5601D168CB7AD44A</identifier><identifier type="DOI">10.1002/mds.20815</identifier><identifier type="ArticleID">MDS20815</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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