Department of Neurology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Department of Urology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Int J Clin Pract. 2021 Dec;75(12):e14873. doi: 10.1111/ijcp.14873. Epub 2021 Sep 22.
To assess the functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG).
A total of 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3-day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence-Short Form" (ICIQ-SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status.
The most common urinary symptoms were nocturia (80.5%), incontinence (61%) and urgency (47%). OABSS was higher in patients than controls (P = .008). Duration of urinary symptoms was longer, and nocturia was more common in late-onset MG (LOMG) than in early-onset MG (EOMG; P = .029, P = .023). The duration of disease and urinary symptoms statistically increased in ACh-Ab (-) group compared with ACh-Ab (+) group (P = .003, P = .027). Night-time urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared with EOMG (P = .003 and P = .01). Residual volume on the US was significantly higher in LOMG than that in EOMG (P = .004). The duration of disease was positively correlated with tQmax and daytime urination frequency (P = .013, r = .48; P = .016, r = .398). A negative association was found between duration of disease and daytime VV (P = .04, r = -.344).
LUT dysfunction may manifest disease in MG, particularly in late-onset forms. The lack of ACh-Ab seemed to prolong the duration of disease and urinary disturbances.
评估重症肌无力（MG）患者下尿路（LUT）的功能。
共纳入 36 例 MG 患者（男 18 例，女 18 例）和 29 例健康对照者。参与者完成了 3 天的排尿日记，并回答了“膀胱过度活动症症状评分”（OABSS）和“国际尿失禁咨询-简短问卷”（ICIQ-SF）问卷。所有患者均行尿流率和超声检查（US）。根据疾病的发病时间和血清学状态对数据进行比较。
最常见的泌尿系统症状为夜尿症（80.5%）、尿失禁（61%）和尿急（47%）。OABSS 在患者中高于对照组（P=0.008）。晚发性 MG（LOMG）的症状持续时间和夜尿症更为常见（P=0.029，P=0.023）。与 ACh-Ab（+）组相比，ACh-Ab（-）组的疾病和泌尿系统症状持续时间更长（P=0.003，P=0.027）。与 EOMG 相比，LOMG 的夜间排尿频率显著增加，白天排尿量（VV）减少（P=0.003 和 P=0.01）。与 EOMG 相比，LOMG 的 US 残余尿量显著升高（P=0.004）。疾病持续时间与 tQmax 和白天排尿频率呈正相关（P=0.013，r=0.48；P=0.016，r=0.398）。疾病持续时间与白天 VV 呈负相关（P=0.04，r=-0.344）。
LUT 功能障碍可能是 MG 疾病的表现，特别是在晚发型中。缺乏 ACh-Ab 似乎延长了疾病和泌尿系统紊乱的持续时间。
