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Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus
T Yamamoto1, R Sakakibara, T Uchiyama
1Neurology Department, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan.
Journal of Neurology, Neurosurgery, and Psychiatry
|February 18, 2005
Summary
Pituitary adenomas impacting the hypothalamus can cause significant lower urinary tract (LUT) dysfunction, affecting both urine storage and voiding. These findings highlight the hypothalamus
Area of Science:
- Neuroscience
- Urology
- Endocrinology
Background:
- The micturition reflex is modulated by suprapontine structures, including the hypothalamus.
- The hypothalamus's specific role in human lower urinary tract (LUT) function remains under-investigated.
Observation:
- Three male patients with pituitary adenomas extending to the hypothalamus presented with diverse LUT symptoms.
- Associated symptoms included weight loss, psychiatric disturbances, gait instability, and visual impairments.
- Urodynamic studies revealed detrusor overactivity during storage and impaired detrusor function or sphincter activity during voiding.
Findings:
- Hypothalamic lesions secondary to pituitary adenomas can lead to severe LUT dysfunction.
- Dysfunction affects both the storage and voiding phases of micturition.
- Surgical and radiation treatments did not fully resolve LUT issues in two patients.
Implications:
- The hypothalamus plays a critical role in regulating human micturition.
- Understanding hypothalamic control of the LUT is crucial for managing complex urological disorders.
- Pituitary adenomas should be considered in the differential diagnosis of unexplained LUT dysfunction.