title: Urodynamic findings in amyotrophic lateral sclerosis patients with lower urinary tract symptoms: Results from a pilot study.
abstract: To determine lower urinary tract symptoms (LUTS) prevalence and urodynamic findings in amyotrophic lateral sclerosis (ALS) patients treated in our hospital.
  
  
  
  Cross-sectional and descriptive study on a cohort of ALS patients. Validated questionnaires (ICIQ-SF, IPSS, and OAB-V8) were self-administered in order to evaluate the presence of LUTS. Symptoms were classified as clinically significant (csLUTS), if any of following scores, IPSS > 7, ICIQ-SF > 0, or OAB-V8 ≥ 8, were present. Urodynamic study was offered to csLUTS patients. Physical examination and prostate ultrasound were also performed.
  
  
  
  Fifty five of seventy nine (70%) ALS patients accepted to participate in the study. Only 24/55 (43.6%) patients met criteria for csLUTS and 13 patients reported urgency urinary incontinence (26.3%). Most of csLUTS patients complained of mixed symptoms (82.6%). QoL measured by IPSS was 2.1 ± 1.5, 20% scoring as mostly dissatisfied or unhappy. Average QoL ICIQ-SF scoring was 3.17 ± 3, 33% complained of moderate to severe bother. Ten of twenty four (41.7%) csLUTS patients consented to UDS. The most frequent finding was detrusor overactivity with obstruction due to non-relaxing external sphincter (five patients) or bladder neck (two patients). Two patients showed normal bladder filling but non-relaxing external sphincter during voiding. UDS was normal in one patient.
  
  
  
  In this small pilot study we found a high prevalence of csLUTS in ALS which are mainly related to a combination of voiding and storage symptoms. In most patients, symptoms are caused by overactive detrusor combined with non-relaxing sphincter. Severity of symptoms and impact in QoL is only moderate but in a subset of patients can be considerable. Neurourol. Urodynam. 36:626-631, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, HUP La Fe, Valencia, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Arlandis
authors.affiliation: Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain.|Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Vázquez-Costa
authors.affiliation: Department of Urology, HUP La Fe, Valencia, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Martínez-Cuenca
authors.affiliation: Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain.|Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.|Department of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sevilla
authors.affiliation: Department of Urology, HUP La Fe, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Boronat
authors.affiliation: Department of Urology, HUP La Fe, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Broseta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology*
keywords: amyotrophic lateral sclerosis; lower urinary tract symptoms; urodynamics