Amarenco G, Kerdraon J, Denys P
Laboratoire d'Urodynamique et de Neurophysiologie, Aulnay-sous-Bois.
Rev Neurol (Paris). 1995 Dec;151(12):722-30.
Two hundred and twenty-five patients with multiple sclerosis and bladder dysfunction were evaluated. 72% had urinary incontinence, 46% dysuria and 24% urinary retention. Detrusor hyperreflexia was the most common finding on cystometry (70%) and 9% of patients had areflexia. Coaxial needle electromyography was performed on all patients and 82% had detrusor-sphincter dyssynergia. Cortical evoked potentials following stimulation of the pudendal nerve were delayed in 72% and sacral evoked latency in 16% especially in patients with incontinence secondary to overactive bladder (25%), suggesting a conus medullaris lesion in these cases. Urologic complications were noted in 40%, with benign lesions in 24% (diverticula, urinary infections) and serious lesions in 16% (hydronephrosis, pyelonephritis, renal reflux). The most common treatment was anticholinergic drugs (efficacy in 92%), alphablockers agents (efficacy in 60%) and autocatheterism in 28%.
对225例患有多发性硬化症和膀胱功能障碍的患者进行了评估。72%的患者有尿失禁，46%有排尿困难，24%有尿潴留。逼尿肌反射亢进是膀胱测压中最常见的发现（70%），9%的患者有无反射。对所有患者进行了同轴针电极肌电图检查，82%的患者有逼尿肌-括约肌协同失调。刺激阴部神经后的皮质诱发电位在72%的患者中延迟，骶部诱发电位在16%的患者中延迟，尤其是在膀胱过度活动继发尿失禁的患者中（25%），提示这些病例存在圆锥马尾病变。40%的患者出现泌尿系统并发症，24%为良性病变（憩室、泌尿系统感染），16%为严重病变（肾积水、肾盂肾炎、肾反流）。最常见的治疗方法是抗胆碱能药物（有效率92%）、α受体阻滞剂（有效率60%）和自行导尿（28%）。
