Urodynamic findings in amyotrophic lateral sclerosis patients with lower urinary tract symptoms: Results from a pilot study

Aims To determine lower urinary tract symptoms (LUTS) prevalence and urodynamic findings in amyotrophic lateral sclerosis (ALS) patients treated in our hospital. Methods Cross‐sectional and descriptive study on a cohort of ALS patients. Validated questionnaires (ICIQ‐SF, IPSS, and OAB‐V8) were self‐administered in order to evaluate the presence of LUTS. Symptoms were classified as clinically significant (csLUTS), if any of following scores, IPSS > 7, ICIQ‐SF > 0, or OAB‐V8 ≥ 8, were present. Urodynamic study was offered to csLUTS patients. Physical examination and prostate ultrasound were also performed. Results Fifty five of seventy nine (70%) ALS patients accepted to participate in the study. Only 24/55 (43.6%) patients met criteria for csLUTS and 13 patients reported urgency urinary incontinence (26.3%). Most of csLUTS patients complained of mixed symptoms (82.6%). QoL measured by IPSS was 2.1 ± 1.5, 20% scoring as mostly dissatisfied or unhappy. Average QoL ICIQ‐SF scoring was 3.17 ± 3, 33% complained of moderate to severe bother. Ten of twenty four (41.7%) csLUTS patients consented to UDS. The most frequent finding was detrusor overactivity with obstruction due to non‐relaxing external sphincter (five patients) or bladder neck (two patients). Two patients showed normal bladder filling but non‐relaxing external sphincter during voiding. UDS was normal in one patient. Conclusions In this small pilot study we found a high prevalence of csLUTS in ALS which are mainly related to a combination of voiding and storage symptoms. In most patients, symptoms are caused by overactive detrusor combined with non‐relaxing sphincter. Severity of symptoms and impact in QoL is only moderate but in a subset of patients can be considerable. Neurourol. Urodynam. 36:626–631, 2017 . © 2016 Wiley Periodicals, Inc.