Awad S A, Wilson J W, Fenemore J, Kiruluta H G
Can J Surg. 1982 May;25(3):259-62.
Urinary tract disorders secondary to multiple sclerosis are common. In this series of 24 patients with multiple sclerosis, 5 had normal function of the detrusor, 3 had detrusor hypotonicity and 16 had detrusor hyperreflexia. The proximal urethra was evaluated using radiologic and electromyographic techniques. These studies showed that 5 patients had a normal urethra, 15 had some degree of somatic dyssynergia and 3 had sympathetic dyssynergia. Detrusor hyperreflexia with somatic dyssynergia was found in 11 patients and was the most common pattern. The therapeutic response to standard pharmacologic preparations was also evaluated. The regimen was based on the clinical and urodynamic findings for each patient. Dicyclomine hydrochloride was the drug of choice for detrusor hyperreflexia, bethanechol chloride for hypotonicity, dantrolene sodium for somatic dyssynergia and phenoxybenzamine hydrochloride for sympathetic dyssynergia. The authors found that most of their patients were amenable to drug therapy, the exception being those with advanced neurologic lesions.
继发于多发性硬化症的泌尿系统疾病很常见。在这组24例多发性硬化症患者中，5例逼尿肌功能正常，3例逼尿肌低张，16例逼尿肌反射亢进。使用放射学和肌电图技术评估近端尿道。这些研究表明，5例患者尿道正常，15例有一定程度的躯体协同失调，3例有交感神经协同失调。11例患者存在伴有躯体协同失调的逼尿肌反射亢进，这是最常见的模式。还评估了对标准药物制剂的治疗反应。治疗方案基于每位患者的临床和尿动力学检查结果。盐酸双环胺是治疗逼尿肌反射亢进的首选药物，氯化氨甲酰甲胆碱用于治疗低张，丹曲林钠用于治疗躯体协同失调，盐酸酚苄明用于治疗交感神经协同失调。作者发现，他们的大多数患者适合药物治疗，晚期神经病变患者除外。
