Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a patient with multiple sclerosis who manifested urinary incontinence as a part of paroxysmal attacks which were characterized by sudden onset, short duration, and frequent repetition. This phenomenon has not been described previously. Urodynamic study during paroxysmal attacks revealed uninhibited detrusor contractions with coordinated relaxation of external urethral sphincter muscle. Neurological examination and magnetic resonance imaging suggested that paroxysmal urinary incontinence was induced by an ectopic excitation of the demyelinating lesion in the right rostral pons, the location of which was similar to the pontine micturition center reported in previous animal experiments. Treatment with carbamazepine, an antiepileptic drug, suppressed the attacks including the associated urinary incontinence.
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PMID:Paroxysmal urinary incontinence associated with multiple sclerosis. 942 42

Clinical symptoms, urodynamic findings, and urological treatment of 35 patients with neurogenic bladder dysfunction caused by Parkinson's disease (11 patients), multiple sclerosis (10 patients), and spinocerebellar degeneration (14 patients) were reviewed retrospectively. Most of the patients had a relatively low stage of disease, when they were first seen by their urologists. Chief urological complaints were of irritation in 63.6% of Parkinson's disease and 64.3% of spinocerebellar degeneration cases, compared with obstruction in 80.0% of multiple sclerosis cases. Cystometry revealed underactive detrusor function in 69.2% of the patients with spinocerebellar degeneration but no abnormalities in the patients with Parkinson's disease or multiple sclerosis. Of 34 patients, excluding one patient lost to follow-up, the period of urological management ranged from one to 44 weeks with a mean of 11.0. The final methods of urinary drainage in 34 patients consisted of voluntary voiding in 20, clean intermittent catheterization in 11 including eight by self catheterization, incontinence into diaper in two, and indwelling catheter in one. Five patients were compelled to change urinary drainage method from voluntary voiding to clean intermittent catheterization because of increasing residual volume in four and progressing bladder deformity in one. However, none of them showed the clinical signs of primary disease progression. These findings indicate that in patients with Parkinson's disease, multiple sclerosis, and spinocerebellar degeneration, the urological symptoms can appear even in the early stage of disease. In addition, close follow-up is important in the urological management of neurogenic bladder patients with these diseases, because the disorders of the lower urinary tract may progress regardless of the status of the primary disease.
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PMID:[Clinical findings of neurogenic bladder in patients with Parkinson's disease, multiple sclerosis and spinocerebellar degeneration]. 943 18

The aim of this study was to investigate the efficacy and tolerance of capsaicin, a neurotoxin for C-fiber afferents, applied intravesically in the treatment of detrusor hyperreflexia. Eleven male and nine female patients who had spinal cord lesions caused by multiple sclerosis (12) or trauma (eight) resulting in detrusor hyperreflexia with urge incontinence and pollakiuria were randomized to receive one intravesical instillation of either 30 mg capsaicin in 100 ml 30% ethanol or 100 ml 30% ethanol alone. The patients were evaluated clinically (voiding diary) and urodynamically (maximum cystometric capacity, maximum detrusor pressure, first and normal desire to void) before and 30 days after the instillation. On day 30, the 10 patients who received capsaicin had significant decreases in 24-h voiding frequency from 9.3+/-6.1 to 6.7+/-3.8 (P=0.016) and leakages from 3.9+/-1.6 to 0.6+/-0.8 (P=0.0008); their maximum cystometric capacity increased from 169+/-68 to 299+/-96 ml (P=0.01) and maximum detrusor pressure decreased from 77+/-24 to 53+/-27 cm H2O. There were no significant changes in the control group. In seven subjects in each group, instillation triggered immediate side effects (suprapubic pain, sensory urgency, flushes, hematuria, autonomic hyperreflexia) that resolved within 2 weeks. Intravesical capsaicin significantly improves clinical and urodynamic parameters of detrusor hyperreflexia in spinal cord-injured patients. Side effects are frequent, tolerable, and identical to those induced by 30% ethanol alone.
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PMID:Capsaicin and neurogenic detrusor hyperreflexia: a double-blind placebo-controlled study in 20 patients with spinal cord lesions. 977 14

Multiple sclerosis is a common neurologic disorder that often affects the genitourinary system. One of the most common symptoms of multiple sclerosis is the hyperactive bladder. These patients will have symptoms that may affect their lifestyle, such as urinary incontinence, urgency, and frequency. They may also suffer from debilitating urinary tract symptoms, such as frequent or recurrent urinary tract infections and also on occasion, damage to the upper urinary tract. Fortunately, the neurogenic bladder dysfunction associated with multiple sclerosis can be treated with a reasonable chance of success. With proper treatment, related symptoms may be brought under control, allowing the physician to concentrate on the more debilitating aspects of this disease.
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PMID:The overactive bladder in multiple sclerosis. 1076 12

The aim of this pilot project was to identify strategies for managing incontinence with women who have multiple sclerosis (MS). The project used the formation of a group in which eight women with MS and four Continence Nurse Advisers (CNAs) and the first author were brought together. In the course of the research process, the women found a voice on a topic previously thought of as taboo. When they realized that they had suffered alone and in silence they felt empowered to act. In this way, the methodology evolved from group work into a participatory action research process (PAR), as the group initiated action. Participants formed a self-help group, and continued to meet with each other after the research had run its course.
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PMID:Identifying strategies for managing urinary incontinence with women who have multiple sclerosis. 1078 27

A 6-year-old female patient with acute disseminated encephalomyelitis associated with poliomyelitis vaccine virus is reported. She had a history of high fever, headache, and gait disturbance. Neurologic examination confirmed spastic triparesis, urinary incontinence, diminution of tactile sensation, and vision deterioration. Hemography, serum laboratory findings, and urinalysis were normal. The cerebrospinal fluid was clear, with normal pressure, 9 leukocytes/mm(3), and 27 mg/dL protein, but the myelin basic protein was elevated to 10.7 ng/mL. T(2)-weighted magnetic resonance imaging disclosed multifocal high-intensity lesions of the spinal cord. The serum polio virus type 2 antibody titer was raised in the acute phase, and polio vaccine virus type 2 was detected in viral cultures of the cerebrospinal fluid and pharynx swab and had undergone an A-G neurovirulence mutation at nucleotide 481. Finally, she had human leukocyte antigen (HLA)-Cw3 and HLA-DR2, to which multiple sclerosis is related in Japan. Thus the cause of ADEM may have been related to her HLA type.
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PMID:Acute disseminated encephalomyelitis associated with poliomyelitis vaccine. 1141 5

Treatment of the neurogenic voiding disorders which occur after spinal cord injury represents one of the most important challenges of rehabilitation. Inadequate management of neurogenic voiding disorders, especially of urinary incontinence, results in impaired quality of life. Moreover, inadequately treated neurogenic voiding disorders may result in medium and long-term renal complications and even death. Treatment of neurogenic disorders, whatever their origin (spinal cord injury, multiple sclerosis, Parkinson's disease), must take into account the gravity of the neurological disease, the potential risks for the upper urinary tract and the expected quality of life. Therefore, each patient must be considered as a separate entity and treated individually. Recent progress in the comprehension of the neurophysiology of the lower urinary tract and the neurophysiopathology of the neurogenic voiding disorders has been followed by the development of new diagnostic and therapeutic tools aimed at improving the patients' health and quality of life.
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PMID:[Neurogenic voiding disorders. Current status of diagnosis and therapy]. 1110 May 16

We report a case of urethral diverticulum with a calculus in a 52-year-old female. She had suffered from transverse myelopathy (flaccid paralysis) as a result of multiple sclerosis. She presented with total incontinence and urinary tract infection that did not respond to antibiotic therapy. We found a urethral diverticulum calculus by X-ray imaging and urethroscopy. Transvaginal urethral diverticulectomy with removal of stone was carried out without any complications. The removed stone was 35 x 31 x 19 mm in size and was composed of magnesium ammonium phosphate and calcium phosphate.
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PMID:[A case of female urethral diverticulum calculus associated with multiple sclerosis]. 1123 24

It is rare to see atopic symptoms in patients with multiple sclerosis(MS). However, it has been reported that in atopic patients, particularly in patients with atopic dermatitis, a benign myelitis occasionally occurs. In the present report, three atopic patients with myelitis were studied clinically and neuroradiologically. All the patients were adult men(Case 1, 2, and 3 were 41-year-old, 31-year-old, and 34-year-old, respectively), and all of them had bronchial asthma without histories of atopic dermatitis. Their manifestations were not severe and were only numbness of upper and/or lower extremities. There was no motor weakness, ataxia, or urinary incontinence. MRI studies revealed a T2-high intensity lesion in the high cervical spinal cord in the two patients(Case 2 and 3) and a T2-high intensity lesion in the lumber spinal cord in the remaining patient(Case 1). Their clinical courses were essentially all benign and well responsive to steroid therapy. Although myelitis of these patients may be a first attack of MS, their findings appear to support a recently emerging concept of the atopic myelitis.
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PMID:[Clinical features of myelitis in patients with atopic symptoms]. 1129 97

We discuss two types of age-associated diseases; aging-dependent such as Alzheimer's disease and congestive heart failure which increase logarithmically with age, versus age-dependent such as multiple sclerosis and amyotrophic lateral sclerosis which occur at proscribed ages, and then occurrence of new cases ceases or diminishes with further aging. Prevention strategies with both types emphasize postponement or delay of onset. The non-fatal aging-dependent diseases and conditions are an accumulating burden as we age, and increase overall morbidity in late years. These include Alzheimer's disease and other dementias, Parkinson's disease, loss of vision and hearing, incontinence, osteoporosis and hip fracture, osteoarthritis and depression. With mortality postponed, we will be living for many years at old and vulnerable ages. Life's quality will be reasonable for most. Still, increasing the chance that all will experience this desirable outcome requires pursuing the means to delay the onset of the physical and social events which we categorize as the non-fatal aging-dependent diseases and conditions. We must recognize that each added year occurs at the tip of an exponential curve where risk is maximal.
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PMID:Age-associated diseases and conditions: implications for decreasing late life morbidity. 1140 87


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