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J Neurol. 2019 Jan;266(1):207-211. doi: 10.1007/s00415-018-9129-8. Epub 2018 Nov 22.

Urinary symptoms, quality of life, and patient satisfaction in genetic and sporadic hereditary spastic paraplegia.

Author information

1
Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany. susanne.schneider@med.uni-muenchen.de.
2
Department of Neurology, Ludwig-Maximilians-University München, Feodor-Lynen-Straße 19, 81377, Munich, Germany. susanne.schneider@med.uni-muenchen.de.
3
Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany.
4
Department of Urology, Christian-Albrechts-University Kiel, Kiel, Germany.

Abstract

BACKGROUND:

Urinary involvement is common in hereditary spastic paraplegias (HSPs), but has rarely been assessed systematically.

METHODS:

We characterized urinary complaints in 71 German HSP patients (mean age 55.4 ± 13.9 years; mean disease duration 20.7 ± 14.3 years; 48% SPG4-positive) using validated clinical rating scales (SCOPA-AUT, ICIQ-SF, ICIQ-LUTSqol). Treatment history and satisfaction with medical care was also assessed.

RESULTS:

74.6% of patients had one or more urological problems, most commonly nocturia and urgency. Incontinence was more severe in women, correlating with SCOPA-AUT. Female gender and SPG4 mutations were associated with higher urinary frequency and severity of urological involvement. QoL was overall reduced, more in women and in SPG4 mutation carriers. Almost 90% consulted a medical specialist; more than half were largely satisfied. 43.4% received oral medication and 5.7% received intravesical botulinum toxin. However, more than one-third of patients remained untreated.

CONCLUSION:

Urinary complaints are common in HSP and should be addressed and treated.

KEYWORDS:

Bladder; Hereditary spastic paraplegia; International Consultation on Incontinence Questionnaire; Nocturia; Quality of life; SCOPA-AUT; SPG4; Satisfaction with care; Urgency; Urinary frequency; Urinary hesitancy; Urinary incontinence

PMID:
30467602
DOI:
10.1007/s00415-018-9129-8

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