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.
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Acknowledgements
We thank Rudolf Kleinsorge on behalf of the Förderverein für HSP-Forschung for help with patient recruitment. The study was awarded the Eugen Rehfisch Prize 2018. We thank Baccara Hizli for administrative assistance.
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SAS: research project: conception, organization, execution; statistical analysis: review and critique; manuscript: writing of the first draft. VB: research project: organization ad execution; statistical analysis: execution; manuscript: review and critique. BM: statistical analysis: design, execution, review and critique; manuscript: review and critique. SK: manuscript: review and critique. GD: manuscript: review and critique.
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SAS was supported by the Else Kröner-Fresenius-Stiftung. GD has received lecture fees from Boston Scientific and has been serving as a consultant for Boston Scientific. He received royalties from Thieme publishers. He is a government employee and receives through his institution funding for his research from the German Research Council, the German Ministry of Education and Research, and Medtronic.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Schneider, S.A., Beckinger, V.E., Möller, B. et al. Urinary symptoms, quality of life, and patient satisfaction in genetic and sporadic hereditary spastic paraplegia. J Neurol 266, 207–211 (2019). https://doi.org/10.1007/s00415-018-9129-8
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DOI: https://doi.org/10.1007/s00415-018-9129-8