Delepaul B, Saussine C, Jacqmin D
Service de Chirurgie Urologique, Hôpitaux Universitaires de Strasbourg.
Prog Urol. 1994 Oct;4(5 Suppl 2):89-96.
Vesicosphincteric disorders are frequent in multiple sclerosis and lead to the diagnosis of this disease in 2 to 5% of cases. The clinical signs are dominated by urgency (60 to 80%), frequency (40 to 60%) and incontinence due to vesical disinhibition. Dysuria (15 to 30%) occurs in an areflexive or hyperactive bladder, associated with vesicosphincteric dyssnergia. These signs are frequently associated (50 to 80%). Cystomanometry shows detrusor hyperactivity in 50 to 78% of cases and hypoactivity in 20 to 40% of cases and dyssnergia is frequent (50 to 80%). There is no correlation between the clinical and urodynamic signs. Consequently, urodynamic studies are useful for establishing a precise urological diagnosis and to prescribe adapted and early treatment due to the long-term risk of upper tract damage.
膀胱括约肌功能障碍在多发性硬化症中很常见，在2%至5%的病例中会由此确诊该疾病。临床症状以尿急（60%至80%）、尿频（40%至60%）以及膀胱抑制解除导致的尿失禁为主。排尿困难（15%至30%）发生在无反射性或活动亢进的膀胱中，与膀胱括约肌协同失调有关。这些症状常同时出现（50%至80%）。膀胱测压显示，50%至78%的病例存在逼尿肌活动亢进，20%至40%的病例存在活动减退，且协同失调很常见（50%至80%）。临床症状与尿动力学表现之间没有相关性。因此，由于存在上尿路损害的长期风险，尿动力学研究对于准确的泌尿系统诊断以及制定合适的早期治疗方案很有用。
