Saito M, Kato K, Kondo A, Miyake K
Department of Urology, Nagoya University School of Medicine.
Hinyokika Kiyo. 1991 Sep;37(9):1005-8.
Bladder dysfunction is one of the major symptomatologies characteristic to HAM (HTLV-I associated myelopathy). Four patients, 3 females and 1 male, were diagnosed by neurologists to have HAM with spastic gait disturbance and increased titer of antibody to HTLV-I. They complained of urge incontinence, bed wetting, difficulty in micturition and/or pollakisuria. Urodynamically, in 3 of them severe uninhibited detrusor contractions were observed. On the other hand, in one case detrusor contractility was lost completely at voiding. In all patients, bladder sensation was well preserved. Corticosteroids and interferon could not improve their urological symptoms. Clean intermittent catheterization (CIC) put on 3 patients who had a significant amount of residue relieved them of urinary incontinence. We believe that HAM in patients suffering from severe difficulty in micturition is a good indication for CIC.
膀胱功能障碍是人类嗜T淋巴细胞病毒I型相关脊髓病（HAM）的主要症状之一。4例患者（3名女性和1名男性）经神经科医生诊断为患有HAM，伴有痉挛性步态障碍且抗人类嗜T淋巴细胞病毒I型抗体滴度升高。他们主诉急迫性尿失禁、尿床、排尿困难和/或尿频。尿动力学检查发现，其中3例存在严重的逼尿肌无抑制性收缩。另一方面，1例患者在排尿时逼尿肌完全丧失收缩力。所有患者的膀胱感觉均保存良好。皮质类固醇和干扰素未能改善他们的泌尿系统症状。对3例有大量残余尿的患者进行清洁间歇性导尿（CIC）后，尿失禁症状得到缓解。我们认为，排尿严重困难的HAM患者是CIC的良好适应证。
