Amarenco P, Amarenco G, Guillevin L, Roullet E, Sobann M, Baudrimont M, Marteau R
Service de Neurologie, Hôpital Saint-Antoine, Paris.
Ann Med Interne (Paris). 1988;139(3):183-5.
Bladder neuropathy was diagnosed in 3 patients with systemic vasculitis (temporal arteritis: 1 case; periarteritis nodosa: 2 cases). Clinical characteristics were: dysuria, diminished or abolished bladder sensation leading to indolent bladder retention. Urodynamic investigation showed hypotonic and underactive detrusor, increased detrusor compliance, hyposensitive bladder, and/or overactive urethral closure. Needle electrode examination showed signs of denervation of periurethral muscles; sacral evoked latencies were increased, favouring pudenal nerve alterations. Symptoms and urodynamic abnormalities resolved following corticosteroid therapy. Clinical and therapeutic implications of bladder neuropathy in necrotizing vasculitis are emphasized.
3例系统性血管炎（颞动脉炎：1例；结节性多动脉炎：2例）患者被诊断为膀胱神经病变。临床特征为：排尿困难、膀胱感觉减退或消失导致无痛性膀胱潴留。尿动力学检查显示逼尿肌低张和活动不足、逼尿肌顺应性增加、膀胱感觉减退和/或尿道关闭过度活跃。针电极检查显示尿道周围肌肉去神经支配的迹象；骶神经诱发潜伏期延长，提示阴部神经改变。皮质类固醇治疗后症状和尿动力学异常消失。强调了膀胱神经病变在坏死性血管炎中的临床和治疗意义。
