200 Section - Urinary Symptoms in Patients with Multiple System Atrophy and Cystometry Findings: Experience from a Tertiary Centre

27 participants with MSA (MSA-Cerebellar=21, MSA-Parkinsonian=6,) with 23 males. Their urinary symptoms were recoded and after evaluation and due preparation, they underwent urodynamic study (filling and voiding cystometry). Age of the participants ranged from 48 to 77 years (Mean 57.6 years, SD 7).  Mean duration of illness was 29.7 months (range 4-84 months, SD 20) and urinary symptoms; 19 months (range 3-66 months, SD 16). The urinary symptoms were; urgency and increased frequency (n=18, 66.7%), feeling of incomplete evacuation and urge urinary incontinence (n=16, 59.3%), nocturia (n=13, 48%), retention of urine (n=10, 37%), straining to void (n=8, 29.6%), stress incontinence (n=3, 11.1%) and incontinence when unaware (n=2, 7.4%). According to cystometry, 77.8% participants had neurogenic detrusor overactivity (n=21),  with more than half had associated detrusor sphincter dyssynergia (n=15, 55.6%). Six participants had acontractile/hypocontractile detrusor. The bladder management was based on cystometry findings and consisted of pharmacotherapy, behavioural and supportive therapy.

Conclusion:

Urinary symptoms are common and diverse in MSA and can either be the initial presentation or can develop later in the disease course. Early cystometry and appropriate management will help in reducing morbidity due to the disease and improve quality of life.