Urodynamic evaluation of bladder function in patients with parkinsonism dominant multiple system atrophy with abnormal urination / 中华神经科杂志

ABSTRACT

Objective@#To investigate the urodynamic characteristics and clinical significance of bladder function in patients with parkinsonism dominant multiple system atrophy (MSA-P) with abnormal urination. @*Methods@#The clinical data of 58 patients with multiple system atrophy (MSA) and urinary dysfunction who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2015 to June 2018 were analyzed. The bladder function status of MSA-P patients was evaluated, and the characteristics of urinary motility examination results were analyzed. @*Results@#According to the diagnostic criteria, 51 patients were MSA, and seven patients were suspicious, all diagnosed as MSA-P. All MSA-P patients had abnormal urination with different symptoms, including dysuria (77.6%), frequent urination (62.1%), urgency (62.1%), urinary incontinence (65.5%), urinary retention (12.1%). Of the MSA-P patients with abnormal urination, the maximum flow rate (Qmax) was (12.46±2.85) ml/s, the average flow rate (Qave) was (5.19±2.06) ml/s, the voided volume was (171.73±11.47) ml, postvoid residual urine was (136.15±10.47) ml, maximal detrusor pressure was (20.78±3.55) cmH2O, bladder compliance was (16.59±2.91) ml/cmH2O, normal desire to void was (223.64±11.02) ml, and maximal capacity was (287.57±12.51) ml. The Qmax, Qave, voided volume, maximal detrusor pressure, bladder compliance, normal desire to void, and maximal capacity of patients with MSA-P with abnormal urination were significantly decreased, while the bladder residual urine volume was significantly increased, with statistically significant differences compared to normal reference values (P<0.05). @*Conclusion@#The urinary motility of bladder function in patients with MSA-P and urinary abnormalities is mainly characterized by decreased bladder compliance and detrusor dysfunction, while urodynamic testing is helpful for early diagnosis.