Petersen T, Pedersen E
Acta Neurol Scand. 1984 Jun;69(6):402-11. doi: 10.1111/j.1600-0404.1984.tb07823.x.
During a period of 2 1/2 years, 198 patients with definite MS were admitted to our neurological department. 88 were investigated neurourodynamically because of distinct voiding dysfunction. 73 patients showed detrusor hyperreflexia, 14 detrusor hyporeflexia or areflexia and one had normal findings. There was no obvious correlation between the occurrence of the symptoms, irritative and obstructive, and the allocation of the patients into different cystometric groups. The predominant symptom was urge incontinence. More men had been treated or were permanently treated with intravesical catheter, but mean residual urine did not show any sex difference. In 36 patients with detrusor hyperreflexia, dyssynergia was observed and was classified into 3 groups. In the group with clonic sphincter EMG activity during voiding, 5 of the patients had dyssynergia because of flexor spasms transmitted to the sphincter. In patients with dyssynergia characterized by increased sphincter activity throughout detrusor contraction, a large mean residual urine was noted, but dyssynergia did not always prevent acceptable emptying. A low rate of complication in the upper urinary tract was observed. Treatment is discussed.
在2年半的时间里，198例确诊为多发性硬化症（MS）的患者入住我们的神经科。其中88例因明显的排尿功能障碍接受了神经泌尿动力学检查。73例患者表现为逼尿肌反射亢进，14例为逼尿肌反射减退或无反射，1例检查结果正常。刺激性和梗阻性症状的出现与患者归入不同膀胱测压组之间没有明显关联。主要症状是急迫性尿失禁。接受膀胱内插管治疗或长期接受该治疗的男性较多，但平均残余尿量没有显示出性别差异。在36例逼尿肌反射亢进的患者中，观察到协同失调并分为3组。在排尿期间括约肌肌电图出现阵挛性活动的组中，5例患者因传入括约肌的屈肌痉挛而出现协同失调。在整个逼尿肌收缩过程中括约肌活动增加所导致协同失调的患者中，平均残余尿量较多，但协同失调并不总是妨碍达到可接受的排空效果。上尿路并发症发生率较低。文中讨论了治疗方法。
