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Urinary retention and sympathetic sphincter obstruction in axonal Guillain–Barré syndrome
Author(s) -
Sakakibara Ryuji,
Uchiyama Tomoyuki,
Tamura Noriko,
Kuwabara Satoshi,
Asahina Masato,
Hattori Takamichi
Publication year - 2007
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20639
Subject(s) - urinary retention , medicine , urethral sphincter , anesthesia , weakness , lumbosacral joint , urology , detrusor muscle , urinary system , surgery , urethra , urinary bladder , anatomy
Abstract A 62‐year‐old woman with axonal Guillain–Barré syndrome developed weakness and urinary retention simultaneously. The retention failed to recover for 10 months even after she regained the ability to walk. The patient exhibited no postural hypotension. Videourodynamics showed that the retention was caused not by the bladder paralysis but rather by internal (sympathetic) sphincter obstruction, which is extremely uncommon in peripheral neuropathies. We started the patient on an alpha‐adrenergic antagonist, urapidil, at 30 mg/day, and this led to successful relaxation of the urethra and reduced the postvoid residual from 200 ml to less than 30 ml. The underlying mechanisms of urinary retention in our patient appeared to involve hyperactive lumbosacral sympathetic nerves. Urinary retention and sympathetic sphincter obstruction can thus be features of axonal Guillain–Barré syndrome. Muscle Nerve, 2006