URINARY SYMPTOMS AND THE NEUROLOGICAL FEATURES OF BLADDER DYSFUNCTION IN MULTIPLE-SCLEROSIS
URINARY SYMPTOMS AND THE NEUROLOGICAL FEATURES OF BLADDER DYSFUNCTION IN MULTIPLE-SCLEROSIS
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DOI：
10.1136/jnnp.56.3.245
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发表时间：
1993-03-01
影响因子：
11
通讯作者：
FOWLER, CJ
中科院分区：
文献类型：
--
作者：
BETTS, CD;DMELLOW, MT;FOWLER, CJ
对一百七十名患有多发性硬化症和膀胱功能障碍的患者进行了评估。重点放在他们的神经学特征和泌尿系统症状之间的关系。泌尿系统症状的严重程度与下肢锥体损伤的程度有关，因此这两个问题都被认为反映了脊柱受累的程度。没有其他神经学特征与膀胱功能障碍相关。逼尿肌反射亢进是膀胱测压时最常见的发现，没有患者出现反射消失。超过一半的患者排尿后残余量显着增加，但症状在预测膀胱排空不良方面基本上不可靠。在这个系列中，只有两名患者有上尿路疾病的证据：两人都患有严重的长期神经系统疾病，并留置导尿管。如果多发性硬化症患者出现刺激性泌尿症状和下肢锥体征，则可预见逼尿肌反射亢进。测量残余体积后可以开始适当的治疗。
One hundred and seventy patients with multiple sclerosis and bladder dysfunction were evaluated. Emphasis was placed on the relationship between their neurological features and urinary symptoms. The severity of the urinary symptoms was related to the degree of pyramidal impairment in the lower limbs so that both problems are thought to reflect the extent of spinal involvement. No other neurological features correlated with bladder dysfunction. Detrusor hyperreflexia was the commonest finding on cystometry and no patient had areflexia. More than half of the patients had a significantly raised post-micturition residual volume but symptoms were largely unreliable in predicting poor bladder emptying. In this series only two patients had evidence of upper tract disease: both men with severe, longstanding neurological disease who had indwelling catheters. Detrusor hyperreflexia can be anticipated in patients with MS who have irritative urinary symptoms and pyramidal signs in their lower limbs. After measurement of the residual volume appropriate treatment can be instituted.