Lower urinary tract function in dementia of Lewy body type

Sokakibara, R.; Ito, T.; Uchiyama, T.; Asahina, M.; Liu, Z.; Yamamoto, T.; Yamanaka, Y.; Hattori, T.
May 2005
Journal of Neurology, Neurosurgery & Psychiatry;May2005, Vol. 76 Issue 5, p729
Academic Journal
Objective: Dementia of Lewy body (DLB) type is the second commonest degenerative cause of dementia and autonomic dysfunction has been recognised in DLB. Lower urinary tract investigated LUT function in DLB by evaluting clincal and urodynamic data Methods: We examined 11 patients (eight men, three women; age range 65-81; disease duration 2-14 years) with probable DLB. Urodynamic studies consisted of: measurement of postvoidresidual in all patients, uroflowmetry in fice, and electromyogrophy (EMG) cystometry in seven. Results: All patients had symptoms of LUT: ruinary inconfinence (urgency type/functional type due to dementia and immobility/both urgency and stress type in 7/2/1 patients, respectively); night-time frequency; urgency; and daytime frequency and voiding difficulty. Seven had postvoid residuals, and three had residual urine voluem <100 ml. Decreased urinary flow was seen in all fice and detrusor overactivity in 5/7 patients who underwent flowmetry and EMG cystometry, respectively. Low compliance detrusor (storage phase, n=2, with bethanechol supersensitivity), an underactive detrusor (n=4), an underactive detrusor (n=1), and detrvsor-sphincler dyssynergia (voiding phase) (n=1) were also seen; 2/3 patients who underwent motor unit potential analysis had neurogenic changes. Conclusion: LUT dysunction is a common feature in DLB, not only due to dementia and immobility, but also to central and peripheral types of somato-autonomic dysfunction.


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