Bladder dysfunction in Duchenne muscular dystrophy: A narrative review.

Area of Science:

• Urology
• Neurology
• Pediatrics

Background:

• Duchenne muscular dystrophy (DMD) is a severe, progressive skeletal muscle disorder.
• Urological complications in DMD include detrusor overactivity, bladder hypocontractility, urinary incontinence, detrusor-sphincter dyssynergia, and urolithiasis.
• This review focuses on bladder dysfunction management in DMD patients.

Purpose of the Study:

• To investigate the incidence of lower urinary tract symptoms (LUTS), defecation problems, urinary tract infections (UTIs), and urolithiasis in children with DMD.
• To assess the impact of urological problems on the quality of life in children with DMD.
• To provide recommendations for bladder dysfunction management in DMD.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Scopus, Embase, Cochrane, and Web of Science.
• Nine non-randomized studies were selected following PRISMA guidelines and analyzed using the PICO framework.
• Study quality was validated using MINORS criteria.

Main Results:

• The prevalence of LUTS in DMD patients ranged from 32% to 85%, with hesitancy, urgency, incontinence, and frequency being most common.
• Concomitant defecation problems were reported in 32% to 70% of patients.
• Information regarding UTIs, urolithiasis, quality of life, and treatment outcomes was sparse.

Conclusions:

• DMD is associated with a high prevalence of urological complications, particularly LUTS and defecation issues.
• There is a significant lack of data on UTIs, urolithiasis, quality of life, and treatment efficacy in DMD.
• Multidisciplinary management, including pediatric urologists, is recommended for addressing LUTS and bowel dysfunction in DMD.