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. © 2016 Wiley Periodicals, Inc.
Neurourology and urodynamics. 2016 Feb 19 [Epub ahead of print]
Salvador Arlandis, Juan Francisco Vázquez-Costa, Esther Martínez-Cuenca, Teresa Sevilla, Francisco Boronat, Enrique Broseta
Department of Urology, HUP La Fe, Valencia, Spain. , Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain. , Department of Urology, HUP La Fe, Valencia, Spain. , Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain. , Department of Urology, HUP La Fe, Valencia, Spain. , Department of Urology, HUP La Fe, Valencia, Spain.