Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?
Identifieur interne : 003382 ( Main/Exploration ); précédent : 003381; suivant : 003383Incomplete emptying and urinary retention in multiple‐system atrophy: When does it occur and how do we manage it?
Auteurs : Takashi Ito [Japon] ; Ryuji Sakakibara [Japon] ; Kosaku Yasuda [Japon] ; Tatsuya Yamamoto [Japon] ; Tomoyuki Uchiyama [Japon] ; Zhi Liu [Japon] ; Tomonori Yamanishi [Japon] ; Yusuke Awa [Japon] ; Kaori Yamamoto [Japon] ; Takamichi Hattori [Japon]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-06-06.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adrenergic alpha-Antagonists (therapeutic use), Adult, Aged, Alpha blocking agent, Catheterization, Cholinergic Agonists (therapeutic use), Disease Progression, Electromyography, Female, Humans, Intermittent, Male, Middle Aged, Multiple System Atrophy (physiopathology), Multiple system atrophy, Nervous system diseases, Urinary Catheterization, Urinary Retention (epidemiology), Urinary Retention (physiopathology), Urinary Retention (surgery), Urinary Retention (therapy), Urinary retention, Urodynamics (physiology), clean intermittent self‐catheterization, multiple‐system atrophy, transurethral sphincterotomy, urinary retention, α‐adrenergic antagonists.
- MESH :
- chemical , therapeutic use : Adrenergic alpha-Antagonists, Cholinergic Agonists.
- epidemiology : Urinary Retention.
- physiology : Urodynamics.
- physiopathology : Multiple System Atrophy, Urinary Retention.
- surgery : Urinary Retention.
- therapy : Urinary Retention.
- Adult, Aged, Disease Progression, Electromyography, Female, Humans, Male, Middle Aged, Urinary Catheterization.
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
Url:
DOI: 10.1002/mds.20815
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-06-06">2006-06-06</date><biblScope unit="vol">21</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="816">816</biblScope><biblScope unit="page" to="823">823</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">3444BDF50F9C3BD17B42D0CC5601D168CB7AD44A</idno><idno type="DOI">10.1002/mds.20815</idno><idno type="ArticleID">MDS20815</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenergic alpha-Antagonists (therapeutic use)</term><term>Adult</term><term>Aged</term><term>Alpha blocking agent</term><term>Catheterization</term><term>Cholinergic Agonists (therapeutic use)</term><term>Disease Progression</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Intermittent</term><term>Male</term><term>Middle Aged</term><term>Multiple System Atrophy (physiopathology)</term><term>Multiple system atrophy</term><term>Nervous system diseases</term><term>Urinary Catheterization</term><term>Urinary Retention (epidemiology)</term><term>Urinary Retention (physiopathology)</term><term>Urinary Retention (surgery)</term><term>Urinary Retention (therapy)</term><term>Urinary retention</term><term>Urodynamics (physiology)</term><term>clean intermittent self‐catheterization</term><term>multiple‐system atrophy</term><term>transurethral sphincterotomy</term><term>urinary retention</term><term>α‐adrenergic antagonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenergic alpha-Antagonists</term><term>Cholinergic Agonists</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Urinary Retention</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Urodynamics</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Multiple System Atrophy</term><term>Urinary Retention</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Urinary Retention</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Urinary Retention</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Disease Progression</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Urinary Catheterization</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Atrophie multisystématisée</term><term>Bloquant α-adrénergique</term><term>Cathétérisme</term><term>Intermittent</term><term>Rétention urinaire</term><term>Système nerveux pathologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml: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</div></front></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Ito, Takashi" sort="Ito, Takashi" uniqKey="Ito T" first="Takashi" last="Ito">Takashi Ito</name></noRegion><name sortKey="Awa, Yusuke" sort="Awa, Yusuke" uniqKey="Awa Y" first="Yusuke" last="Awa">Yusuke Awa</name><name sortKey="Hattori, Takamichi" sort="Hattori, Takamichi" uniqKey="Hattori T" first="Takamichi" last="Hattori">Takamichi Hattori</name><name sortKey="Liu, Zhi" sort="Liu, Zhi" uniqKey="Liu Z" first="Zhi" last="Liu">Zhi Liu</name><name sortKey="Sakakibara, Ryuji" sort="Sakakibara, Ryuji" uniqKey="Sakakibara R" first="Ryuji" last="Sakakibara">Ryuji Sakakibara</name><name sortKey="Uchiyama, Tomoyuki" sort="Uchiyama, Tomoyuki" uniqKey="Uchiyama T" first="Tomoyuki" last="Uchiyama">Tomoyuki Uchiyama</name><name sortKey="Yamamoto, Kaori" sort="Yamamoto, Kaori" uniqKey="Yamamoto K" first="Kaori" last="Yamamoto">Kaori Yamamoto</name><name sortKey="Yamamoto, Tatsuya" sort="Yamamoto, Tatsuya" uniqKey="Yamamoto T" first="Tatsuya" last="Yamamoto">Tatsuya Yamamoto</name><name sortKey="Yamanishi, Tomonori" sort="Yamanishi, Tomonori" uniqKey="Yamanishi T" first="Tomonori" last="Yamanishi">Tomonori Yamanishi</name><name sortKey="Yasuda, Kosaku" sort="Yasuda, Kosaku" uniqKey="Yasuda K" first="Kosaku" last="Yasuda">Kosaku Yasuda</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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