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Dysautonomie et troubles urinaires au cours de la sclérose en plaques

Dysautonomia and urinary disorders in multiple sclerosis

  • Article Original / Original Article
  • Published:
Pelvi-périnéologie

Résumé

Les symptômes de dysautonomie sont fréquents au cours de la sclérose en plaques (SEP).

Matériel et méthodes

Nous avons investigué 65 SEP (âge moyen de 47,5 ans) avec troubles urinaires, par scores de symptômes, bilan urodynamique, tests cardiovasculaires de la fonction autonome et étude des réponses cutanées sympathiques.

Résultats

Quarante-cinq patients avaient une incontinence urinaire, 48 une dysurie, 14 une rétention urinaire et 13 une incontinence fécale. Le bilan urodynamique objectivait un détrusor hyperactif dans 46 cas et un détrusor hypoactif dans quatre cas. Vingt-cinq patients sur 65 (38 %) avaient une dysautonomie sans corrélation avec la typologie clinique ou urodynamique ou avec la gravité de la maladie.

Conclusion

La dysautonomie est fréquente au cours de la SEP et peut être considérée comme un des facteurs physiopathologiques des troubles urinaires.

Abstract

Symptoms related to alterations of the autonomic nervous system are frequent in patients with multiple sclerosis (MS).

Material and methods

We investigated 65 MS patients (mean age 47,5 years) with urological dysfunction by means symptom scores and urodynamic investigation, cardiovascular autonomic function tests (orthostatic hypotension testing, Valsalva test, deep breath test, cold pressor test) and sympathtetic skin responses.

Results

Forty-five patients presenting with urinary incontinence, 48 difficulties to empty the bladder, 14 urinary retention and 13 fecal incontinence. Urodynamic investigation demonstrated 46 overactive detrusor and 4 underactive detrusor. 25/65 (38%) patients had dysautonomia without correlation neither with clinical or urodynamic data, nor gravity of multiple sclerosis (EDSS).

Conclusion

Dysautonomia is frequent in MS and can be considered as one of the pathophysiological mechanism of urinary disorders in this disease.

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Authors and Affiliations

  1. Service de neuro-urologie et d’explorations périnéales, AP-HP, UMRS 731 UPMC, F-75012, Paris, France

    G. Amarenco, K. Hubeaux, S.-S Ismaël, P. Raibaut & E. Lapeyre

  2. Service d’exploration périnéale et de rééducation neurologique, hôpital Rothschild, 33, boulevard de Picpus, F-75012, Paris, France

    G. Amarenco

Authors
  1. G. Amarenco
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  2. K. Hubeaux
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  3. M. Jousse
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  4. S.-S Ismaël
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  5. P. Raibaut
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  6. E. Lapeyre
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Correspondence to G. Amarenco.

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Amarenco, G., Hubeaux, K., Jousse, M. et al. Dysautonomie et troubles urinaires au cours de la sclérose en plaques. Pelv Perineol 5, 205–209 (2010). https://doi.org/10.1007/s11608-010-0314-1

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  • DOI: https://doi.org/10.1007/s11608-010-0314-1

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