Highlights
- •Lower urinary tract symptoms and neurogenic bladder are frequent in ALS patients.
- •Clinical characteristics of patients with and without lower urinary tract symptoms are similar.
- •Early urinary symptoms and neurogenic bladder appears to be a sign of poor prognosis.
Abstract
Introduction
Lower urinary tract symptoms (LUTS) are frequent in motor neuron disease (MND) patients,
but clinical factors related to them are unknown. We describe differences in LUTS
among MND phenotypes and their relationship with other clinical characteristics, including
prognosis.
Methods
For this study, we collected clinical data of a previously published cohort of patients
diagnosed with classical amyotrophic lateral sclerosis (cALS), progressive muscular
atrophy (PMA) or primary lateral sclerosis (PLS) with and without LUTS. Familial history
was recorded and the C9ORF72 expansion was analysed in the entire cohort. Patients
were followed-up for survival until August 2016.
Results
Fifty-five ALS patients (37 cALS, 10 PMA and 8 PLS) were recruited. Twenty-four reported
LUTS and neurogenic bladder (NB) could be demonstrated in nine of them. LUTS were
not influenced by age, phenotype, disability, cognitive or behavioural impairment,
or disease progression, but female sex appeared to be a protective factor (OR = 0.39, p = 0.06). Neither family history nor the C9ORF72 expansion was linked to LUTS or NB.
In the multivariate analysis, patients reporting LUTS early in the disease course
tended to show poorer survival.
Conclusions
In this study, LUTS appear to be more frequent in male MND patients, but are not related
to age, clinical or genetic characteristics. When reported early, LUTS could be a
sign of rapid disease spread and poor prognosis. Further prospective longitudinal
and neuroimaging studies are warranted to confirm this hypothesis.
Keywords
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Article info
Publication history
Published online: May 02, 2017
Accepted:
April 30,
2017
Received in revised form:
April 28,
2017
Received:
December 10,
2016
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
