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Genitourinary dysfunction in multiple system atrophy: clinical features and treatment in 62 cases
R O Beck1, C D Betts, C J Fowler
1Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, England.
The Journal of Urology
|May 1, 1994
Summary
Multiple system atrophy (MSA) causes progressive neurological damage affecting urogenital function. Early diagnosis and non-surgical treatments significantly improve continence for most patients.
Area of Science:
- Neurology
- Urology
Background:
- Multiple system atrophy (MSA) is a neurodegenerative disorder impacting the central nervous system.
- Specific neurological sites affected by MSA are crucial for controlling urogenital function.
Purpose of the Study:
- To describe the neuro-urological features of patients with multiple system atrophy.
- To evaluate the effectiveness of non-operative treatments for urogenital dysfunction in MSA.
Main Methods:
- Electromyography (EMG) of urethral or anal sphincters was used for diagnosis.
- Clinical assessment of urogenital symptoms including impotence, urinary incontinence, and voiding difficulties.
- Evaluation of treatment outcomes for intermittent catheterization, anticholinergic medication, and desmopressin spray.
Main Results:
- All patients exhibited abnormal sphincter EMG, a key diagnostic finding.
- High prevalence of impotence (96%) in men and stress incontinence (57%) in women.
- Non-operative treatments improved continence in 82% of patients, with poor surgical outcomes.
Conclusions:
- Recognizing MSA is critical for timely and effective management of neuro-urological symptoms.
- Non-operative interventions offer significant improvements in continence for MSA patients.
- Surgical interventions for urogenital symptoms in MSA yield poor results.