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Related Experiment Videos

Urinary dysfunction in Duchenne muscular dystrophy

J B Caress1, M J Kothari, S B Bauer

  • 1Division of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Muscle & Nerve
|July 1, 1996
PubMed
Summary
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Urinary incontinence in Duchenne muscular dystrophy (DMD) is often caused by upper motor neuron (UMN) dysfunction, not muscle weakness. Spinal issues like scoliosis or surgery complications are likely culprits.

Area of Science:

  • Neurology
  • Urology
  • Genetics

Background:

  • Duchenne muscular dystrophy (DMD) typically spares sphincter muscles.
  • Urinary incontinence can occur late in DMD, but its cause is unclear.

Purpose of the Study:

  • To investigate the etiology of urinary dysfunction in boys with DMD.
  • To differentiate between upper motor neuron (UMN), lower motor neuron (LMN), and myopathic causes.

Main Methods:

  • Clinical examination by neurologist and urologist.
  • Urodynamic and electrophysiological assessments.
  • Classification of lesions as UMN, LMN, or myopathic.

Main Results:

  • Five of seven boys had UMN abnormalities (uninhibited contractions or bladder/sphincter dyssynergy).

Related Experiment Videos

  • One boy had an LMN lesion; none had myopathic lesions.
  • Five boys had undergone spinal fusion for scoliosis.

    • Conclusions:

    • Urinary incontinence in DMD is primarily due to UMN dysfunction.
    • Detrusor or external sphincter myopathy is unlikely.
    • Severe scoliosis or spinal fusion complications are probable causes of UMN abnormalities.