Erectile and urinary dysfunction may be the presenting features in patients with multiple system atrophy: a retrospective study

摘要: Multiple system atrophy (MSA) is a progressive neurodegenerative disease characterized by parkinsonism and cerebellar, autonomic, urinary, and/or pyramidal dysfunction. Urinary erectile dysfunction (ED) symptoms are prominent early features in men with MSA. Autonomic failure, considered until recently to be the cause of ED these men, commonly expressed through orthostatic hypotension (OH). The aim this retrospective study examine chronological relationship between development urogenital those OH patients diagnosed MSA discuss its significance aetiology patients. A total 71 male patients, referred Uro-Neurology department diagnosis 'probable MSA', were reviewed terms 'autonomic' only--OH lower urinary tract symptoms, accompanied ED--present at time their referral. Laboratory investigations including anal sphincter EMG autonomic function tests (AFTs) performed 75 90% respectively. At presentation, complaints recorded 96% all that was inquired about. onset had preceded bladder 58% 91% men. Bladder also 76% Sphincter abnormal AFTs 77% tested. Almost troublesome symptoms. showed similar sensitivity relating common probable often not OH. earlier occurrence suggests lack causal hypotension. notion possibly affects dopaminergic mechanism discussed.