Neurological diseases that cause detrusor hyperactivity with impaired contractile function

Detrusor hyperactivity with impaired contractile function (DHIC) was originally described in elderly women. It has not previously been well known whether neurological diseases cause DHIC. We investigated which neurological diseases commonly cause DHIC in our laboratory.

We searched for DHIC in our laboratory's computerized database of 1,514 case records, which included a lower urinary tract (LUT) symptom questionnaire and urodynamic study results. DHIC was defined as the presence of both (1) detrusor overactivity during the storage phase, and (2) underactive detrusor contraction during the evacuation phase.

Two hundred and seventeen patients met the criteria for DHIC: 122 men and 95 women; mean age, 63 years. The neurological diseases that caused DHIC included Parkinsonian syndrome (18%), multiple system atrophy (18%), progressive supranuclear palsy/corticobasal degeneration (14%), multiple cerebral infarction (MCI) (12%), multiple sclerosis/acute disseminated encephalomyelitis (18%), spinal cord lesions (15%), and cervical spondylotic myelopathy (CS) (10%).

The present study revealed that a wide spectrum of neurological disorders could cause DHIC.