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Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study

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...

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Autores principales: Eschlböck, Sabine, Kiss, Gustav, Krismer, Florian, Fanciulli, Alessandra, Kaindlstorfer, Christine, Raccagni, Cecilia, Seppi, Klaus, Kiechl, Stefan, Panicker, Jalesh N., Wenning, Gregor K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485589/
https://www.ncbi.nlm.nih.gov/pubmed/34631941
http://dx.doi.org/10.1002/mdc3.13307
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author Eschlböck, Sabine
Kiss, Gustav
Krismer, Florian
Fanciulli, Alessandra
Kaindlstorfer, Christine
Raccagni, Cecilia
Seppi, Klaus
Kiechl, Stefan
Panicker, Jalesh N.
Wenning, Gregor K.
author_facet Eschlböck, Sabine
Kiss, Gustav
Krismer, Florian
Fanciulli, Alessandra
Kaindlstorfer, Christine
Raccagni, Cecilia
Seppi, Klaus
Kiechl, Stefan
Panicker, Jalesh N.
Wenning, Gregor K.
author_sort Eschlböck, Sabine
collection PubMed
description 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.
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spelling pubmed-84855892021-10-07 Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study Eschlböck, Sabine Kiss, Gustav Krismer, Florian Fanciulli, Alessandra Kaindlstorfer, Christine Raccagni, Cecilia Seppi, Klaus Kiechl, Stefan Panicker, Jalesh N. Wenning, Gregor K. Mov Disord Clin Pract Research Articles 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. John Wiley & Sons, Inc. 2021-07-21 /pmc/articles/PMC8485589/ /pubmed/34631941 http://dx.doi.org/10.1002/mdc3.13307 Text en © 2021 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Eschlböck, Sabine
Kiss, Gustav
Krismer, Florian
Fanciulli, Alessandra
Kaindlstorfer, Christine
Raccagni, Cecilia
Seppi, Klaus
Kiechl, Stefan
Panicker, Jalesh N.
Wenning, Gregor K.
Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title_full Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title_fullStr Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title_full_unstemmed Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title_short Urodynamic Evaluation in Multiple System Atrophy: A Retrospective Cohort Study
title_sort urodynamic evaluation in multiple system atrophy: a retrospective cohort study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485589/
https://www.ncbi.nlm.nih.gov/pubmed/34631941
http://dx.doi.org/10.1002/mdc3.13307
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