Lower urinary tract dysfunction in patients with functional movement disorders

Published:December 29, 2015DOI:


      • We evaluate urinary lower urinary tract symptoms in patients with functional movement disorders.
      • Lower urinary tract symptoms were seen in 20% patients of the 150 studied patients.
      • Patients with fixed dystonia are more likely to report lower urinary tract symptoms.
      • Specialist investigation and treatment can lead to improvement in these patients.



      Functional movement disorders (FMD) are not associated with the kind of structural or biochemical alterations seen in other movement disorders and therefore would be unlikely to be associated with lower urinary tract (LUT) dysfunction. However, LUT symptoms have been observed in patients with FMD.


      To evaluate the frequency and pattern of LUT symptoms, their possible nature and the impact they have on the quality of life of patients with FMD.


      The clinical records of patients with FMD were reviewed retrospectively and patients reporting LUT symptoms were invited to complete standardised validated questionnaires—Urinary Symptom Profile (USP) and Short Form—Qualiveen (SFQ). Management of LUT dysfunction was also reviewed.


      Out of the 150 patients with clinically established (n = 97) or probable (n = 53) FMDs, thirty (20%) self-reported LUT symptoms. Twenty two of these completed the USP and SFQ questionnaires. Overactive bladder symptoms were most commonly reported (n = 14; 63.6%). Patients with fixed dystonia reported more severe LUT symptoms and had higher SFQ scores as compared to patients with other FMDs (p = 0.01). Five patients with significant LUT symptoms had been referred to uroneurology. Of them, three had urinary retention managed with sacral neuromodulation, two had overactive bladder and were managed conservatively.


      LUT dysfunction can be seen in 20% patients with FMD. Patients with fixed dystonia are more likely to report LUT dysfunction which can be severe. It may be advisable to ask for LUT symptoms in all patients with FMD and be more proactive in referring them for specialist investigation and treatment.


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        • Panicker J.
        • Batla A.
        Chapter 29 — lower urinary tract dysfunction and the nervous system.
        in: Josephson M.J.A.A. Aminoff's Neurology and General Medicine. fifth ed. Academic Press, Boston2014: 613-631
        • Edwards M.J.
        • Fotopoulou A.
        • Parees I.
        Neurobiology of functional (psychogenic) movement disorders.
        Curr. Opin. Neurol. 2013; 26: 442-447
        • Williams D.T.
        • Ford B.
        • Fahn S.
        Phenomenology and psychopathology related to psychogenic movement disorders.
        Adv. Neurol. 1995; 65: 231-257
        • Haab F.
        • Richard F.
        • Amarenco G.
        • Coloby P.
        • Arnould B.
        • Benmedjahed K.
        • et al.
        Comprehensive evaluation of bladder and urethral dysfunction symptoms: development and psychometric validation of the Urinary Symptom Profile (USP) questionnaire.
        Urology. 2008; 71: 646-656
        • Bonniaud V.
        • Bryant D.
        • Parratte B.
        • Guyatt G.
        Development and validation of the short form of a urinary quality of life questionnaire: SF—Qualiveen.
        The Journal of urology. 2008; 180: 2592-2598
        • Quek K.F.
        • Low W.Y.
        • Razack A.H.
        • Loh C.S.
        A Malaysian study on the reliability and validity of the Health-Related Quality of Life Questionnaire (HRQOL-20) in urological patients.
        The Medical journal of Malaysia. 2001; 56: 293-301
        • Association A.P.
        Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®.
        American Psychiatric Association, 2000
        • Hoeritzauer I.
        • Stone J.
        • Fowler C.
        • Elneil-Coker S.
        • Carson A.
        • Panicker J.
        Fowler's syndrome of urinary retention: a retrospective study of co-morbidity.
        Neurourol.Urodyn. 2015;
        • Sakakibara R.
        • Uchiyama T.
        • Awa Y.
        • Liu Z.
        • Yamamoto T.
        • Ito T.
        • et al.
        Psychogenic urinary dysfunction: a uro-neurological assessment.
        Neurourol.Urodyn. 2007; 26: 518-524
        • Kassavetis P.
        • Batla A.
        • Parees I.
        • Saifee T.A.
        • Schrag A.
        • Cordivari C.
        • et al.
        Joint hypermobility syndrome: a risk factor for fixed dystonia?.
        Mov. Disord. 2012; 27: 1070
        • Panicker J.N.
        • De Seze M.
        • Fowler C.J.
        Neurogenic lower urinary tract dysfunction.
        Handb. Clin. Neurol. 2013; 110: 209-220
        • Mastoroudes H.
        • Giarenis I.
        • Cardozo L.
        • Srikrishna S.
        • Vella M.
        • Robinson D.
        • et al.
        Lower urinary tract symptoms in women with benign joint hypermobility syndrome: a case–control study.
        International urogynecology journal. 2013; 24: 1553-1558