title: Prevalence and mechanism of bladder dysfunction in Guillain-Barré Syndrome.
abstract: OBJECTIVE
  To examine the prevalence and mechanism of urinary dysfunction in GBS.
  
  
  METHODS
  Urinary symptoms were observed and neurological examinations made repeatedly during hospitalization of 65 consecutive patients with clinico-neurophysiologically definite GBS. The patients included 41 men, 24 women; mean age, 41 years old; mean Hughes motor grade, 3; AIDP, 28, AMAN, 37. Urodynamic studies consisted of uroflowmetry, measurement of post-micturition residuals, medium-fill water cystometry, and external anal sphincter electromyography.
  
  
  RESULTS
  Urinary dysfunction was observed in 27.7% of GBS cases (urinary retention, 9.2%). Urinary dysfunction was related to the Hughes motor grade (P < 0.05), defecatory dysfunction (P < 0.05), age (P < 0.05), and negatively related to serum IgG class anti-ganglioside antibody GalNAc-GD1a (P < 0.05). Urinary dysfunction was more common in AIDP (39%) than in AMAN (19%). No association was found between antibody titer against neuronal nicotinic acetylcholine receptors and urinary dysfunction. Urodynamic studies in nine patients, mostly performed within 8 weeks after disease onset, revealed post-void residual in 3 (mean 195 ml), among those who were able to urinate; decreased bladder sensation in 1; detrusor overactivity in 8; low compliance in 1; underactive detrusor in 7 (both overactive and underactive detrusor in 5); and nonrelaxing sphincter in 2.
  
  
  CONCLUSIONS
  In our series of GBS cases, 27.7% of the patients had urinary dysfunction, including urinary retention in 9.2%. Underactive detrusor, overactive detrusor, and to a lesser extent, hyperactive sphincter are the major urodynamic abnormalities. The underlying mechanisms of urinary dysfunction appear to involve both hypo- and hyperactive lumbosacral nerves. Neurourol. Urodynam. 28:432-437, 2009. (c) 2009 Wiley-Liss, Inc.
authors.affiliation: Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan. sakakibara@sakura.med.toho-u.ac.jp
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Awa
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
authors.forename: Steven
authors.initials: S
authors.lastname: Vernino
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kishi
authors.forename: Kohji
authors.initials: K
authors.lastname: Shirai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology; D001323:Autoantibodies / Q000097:blood; D003672:Defecation; D003950:Diagnostic Techniques, Urological; D004576:Electromyography; D005260:Female; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011978:Receptors, Nicotinic / Q000276:immunology; D012720:Severity of Illness Index; D013127:Spinal Nerves / Q000503:physiopathology; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D005732:Gangliosides; D011978:Receptors, Nicotinic