Prevalence and mechanism of bladder dysfunction in Guillain-Barré syndrome

Ryuji Sakakibara, Tomoyuki Uchiyama, Satoshi Kuwabara, Masahiro Mori, Takashi Ito, Tatsuya Yamamoto, Yusuke Awa, Chiharu Yamaguchi, Nobuhiro Yuki, Steven Vernino, Masahiko Kishi, Kohji Shirai

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26 Scopus citations

Abstract

Aim: To examine the prevalence and mechanism of urinary dysfunction in GBS. Methods: Urinary symptoms were observed and neurological examinations made repeatedly during hospitalization of 65 consecutive patients with clinico-neurophysiologically definite GBS. The patients included 41 men, 24 women; mean age, 41 years old; mean Hughes motor grade, 3; AIDP, 28, AMAN, 37. Urodynamic studies consisted of uroflowmetry, measurement of post-micturition residuals, medium-fill water cystometry, and external anal sphincter electromyography. Results: Urinary dysfunction was observed in 27.7% of GBS cases (urinary retention, 9.2%). Urinary dysfunction was related to the Hughes motor grade (P < 0.05), defecatory dysfunction (P < 0.05), age (P < 0.05), and negatively related to serum IgG class anti-ganglioside antibody GalNAc-GD1a (P < 0.05). Urinary dysfunction was more common in AIDP (39%) than in AMAN (19%). No association was found between antibody titer against neuronal nicotinic acetylcholine receptors and urinary dysfunction. Urodynamic studies in nine patients, mostly performed within 8 weeks after disease onset, revealed post-void residual in 3 (mean 195 ml), among those who were able to urinate; decreased bladder sensation in 1; detrusor overactivity in 8; low compliance in 1; underactive detrusor in 7 (both overactive and underactive detrusor in 5); and nonrelaxing sphincter in 2. Conclusion: In our series of GBS cases, 27.7% of the patients had urinary dysfunction, including urinary retention in 9.2%. Underactive detrusor, overactive detrusor, and to a lesser extent, hyperactive sphincter are the major urodynamic abnormalities. The underlying mechanisms of urinary dysfunction appear to involve both hypo- and hyperactive lumbosacral nerves.

Original languageEnglish (US)
Pages (from-to)432-437
Number of pages6
JournalNeurourology and urodynamics
Volume28
Issue number5
DOIs
StatePublished - Jul 13 2009

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Keywords

  • Acute inflammatory demyelinating polyneuropathy
  • Acute motor axonal neuropathy
  • Autonomic dysfunction
  • Bladder dysfunction
  • Guillain-Barré syndrome

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

Sakakibara, R., Uchiyama, T., Kuwabara, S., Mori, M., Ito, T., Yamamoto, T., Awa, Y., Yamaguchi, C., Yuki, N., Vernino, S., Kishi, M., & Shirai, K. (2009). Prevalence and mechanism of bladder dysfunction in Guillain-Barré syndrome. Neurourology and urodynamics, 28(5), 432-437. https://doi.org/10.1002/nau.20663