title: Time-dependent changes and gender differences in urinary dysfunction in patients with multiple system atrophy.
abstract: OBJECTIVE
  Because time-dependent changes and gender differences in urinary dysfunction in patients with multiple system atrophy (MSA) are yet unknown, we aimed to determine these parameters through a combination of urodynamic examination and the results of a questionnaire on urinary symptoms.
  
  
  METHODS
  We retrospectively reviewed 66 patients with MSA who responded to a urinary symptoms questionnaire and underwent urodynamic examination more than twice. The participants' mean age was 62 years and mean disease duration at the first urodynamic examination was 3.2 years. Mean duration between the first and second urodynamic examination was 441 days.
  
  
  RESULTS
  With regard to overall (both genders) time-dependent change, none of the urinary symptoms showed significant differences. In the urodynamic examination there were significant differences in reduced urine flow, increased post-void residuals, and decreased detrusor contractility at the second examination. With regard to gender differences, at the first examination, night-time urinary frequency, and voiding symptoms were significantly more severe in male than in female patients; however, at the second examination, except for urinary urgency, gender differences were not observed for any other symptoms. In urodynamic examination, the degree of detrusor contraction was significantly less in male patients at the first examination. However, no significant differences were found in urodynamic examination at the second examination.
  
  
  CONCLUSIONS
  The present study indicates that voiding dysfunction progressed without significant worsening of voiding symptoms. In addition, gender differences are important in evaluating urinary dysfunction being basically less severe in female than in male patients, at least during the early stage. Neurourol. Urodynam. 33:516-523, 2014. © 2013 Wiley Periodicals, Inc.
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakakibara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaguchi
authors.forename: Sayaka
authors.initials: S
authors.lastname: Ohno
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yanagisawa
authors.forename: Takamichi
authors.initials: T
authors.lastname: Hattori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D001003:Anal Canal / Q000503:physiopathology; D015331:Cohort Studies; D018450:Disease Progression; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014551:Urinary Tract / Q000503:physiopathology*; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*
keywords: gender differences; multiple system atrophy; time-dependent changes; urinary dysfunction; urodynamic study