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Lower urinary tract dysfunction in patients with dysautonomia.

Melissa St Aubin1, Anand Shridharani1, Alexandru C Barboi1

  • 1Froedtert and Medical College of Wisconsin, Milwaukee, WI, USA.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|November 5, 2015
PubMed
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Dysautonomia affects at least 10% of patients, with females predominantly experiencing bladder dysfunction. Most patients with urinary symptoms show detrusor overactivity and are successfully treated with non-operative therapies.

Keywords:
DysautonomiaLower urinary tract dysfunctionTreatment

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Area of Science:

  • Urology
  • Neurology
  • Nephrology

Background:

  • Dysautonomia, a condition affecting the autonomic nervous system, can manifest with a range of urinary symptoms.
  • Understanding the specific types of bladder dysfunction in dysautonomia is crucial for effective management.

Purpose of the Study:

  • To define the urologic complaints, urodynamic findings, and treatment outcomes in patients with dysautonomia-related urinary symptoms.
  • To characterize the spectrum of lower urinary tract dysfunction in patients with dysautonomia.

Main Methods:

  • Retrospective review of patients with dysautonomia and lower urinary tract dysfunction (2005-2015).
  • Analysis of chief urologic complaints, urodynamic studies, and treatment modalities.
  • Evaluation included history, physical, urinalysis, post-void bladder ultrasound, and urodynamics.

Main Results:

  • 10% of dysautonomia patients (82/815) presented with lower urinary tract dysfunction; 84% were female.
  • Urinary urgency ± incontinence (61%) and hesitancy (23%) were common complaints.
  • Detrusor overactivity ± incontinence was found in 50% of patients, often not correlating with initial complaints. Treatments were primarily non-operative.

Conclusions:

  • Lower urinary tract dysfunction affects at least 10% of dysautonomia patients, predominantly females.
  • Patient-reported symptoms do not reliably predict urodynamic findings.
  • Detrusor overactivity is common, and most patients respond well to medical or physical therapy.