Detrusor areflexia in a patient with myasthenia gravis

Myasthenia gravis (MG) is a common neuromuscular disorder, however, voiding dysfunction in conjunction with MG is rare. A review of the literature yielded only 7 prior reports of such a combination. Most of the reported cases involved incontinence in males which developed after a transurethral resection of the prostate. Only 3 cases described de novo voiding dysfunction. We report a fourth patient. In all 4 cases of de novo dysfunction, the voiding problem either heralded a new diagnosis of MG or an exacerbation of the disease process. It is hypothesized that autonomic dysfunction in patients with MG might indicate a unique subset with a worse prognosis.