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Urological dysfunction in patients with hereditary spastic paraplegia
Author(s) -
Joussain Charles,
Levy Jonathan,
Charlanes Audrey,
Even Alexia,
Falcou Laetitia,
Chartier Kastler Emmanuel,
Denys Pierre
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23957
Subject(s) - medicine , lower urinary tract symptoms , hereditary spastic paraplegia , urinary system , paraplegia , cohort , incidence (geometry) , erectile dysfunction , urinary incontinence , spastic , urology , physical therapy , prostate , spinal cord , biochemistry , chemistry , physics , optics , cancer , cerebral palsy , psychiatry , gene , phenotype
Abstract Aims Purposes of this study were to describe lower urinary tract symptoms (LUTS) and related urodynamic patterns in patients with hereditary spastic paraplegia (HSP), and to characterize LUTS management and associated uronephrological complications. Methods We retrospectively reviewed medical files of HSP patients, consecutively followed in our Physical and Rehabilitation Medicine Department between 1999 and 2016. Clinical, urodynamic, and radiological data were collected and analyzed. Different treatments which have been prescribed and uronephrological complications were also recorded. Patients with other neurological or urological diseases were excluded. Results Thirty‐three patients with HSP were included. Mean duration of follow‐up was 8.1 ± 5 years, mean age 62 ± 14 years, and 70% were men. The most frequent LUTS was urgency and voiding dysfunction (both 69.7%). Incontinence and retention with a significant postvoid residue above 100 mL accounted for 66.7% and 57.6% of initial symptoms respectively. Neurogenic detrusor overactivity was diagnosed in 80.7% of patients. Two‐thirds of our cohort were treated with anticholinergics and 9.1% required intradetrusor botulinum‐toxin injections. Only 27.3% of patients performed clean intermittent self‐catheterization. Febrile urinary tract infections (21.2%), urolithiasis (15,1%), hydronephrosis (6%), and chronic renal failure (9.1%) were found. Conclusion Given their high prevalence and the risk of uronephrological complications, LUTS should be systematically assessed in HSP patients. The systematic screening of urological dysfunction in this population would improve its management, decrease the incidence of uronephrological complications, and increase the quality of life.