Urinary and erectile dysfunction in multiple system atrophy (MSA)

• Published in: Neurourology and urodynamics Vol. 27; no. 1; pp. 22 - 27
• Main Authors: Papatsoris, A.G., Papapetropoulos, S., Singer, C., Deliveliotis, C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.01.2008
• Subjects: erectile dysfunction; Erectile Dysfunction - etiology; Erectile Dysfunction - physiopathology; Humans; Male; multiple system atrophy; Multiple System Atrophy - complications; Multiple System Atrophy - diagnosis; Multiple System Atrophy - physiopathology; Phenotype; review; treatment algorithm; urinary dysfunction; Urinary Tract - physiopathology; Urinary Tract Infections - etiology; Urination Disorders - etiology
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.20461

Multiple system atrophy (MSA) is a neurodegenerative disease of undetermined etiology that occurs sporadically and manifests itself as a combination of parkinsonian, autonomic, cerebellar, and pyramidal signs. Despite the lack of effective therapies, some of the symptoms may be, at least temporarily, improved with adequate symptomatic therapies. Urinary and erectile dysfunction (ED) symptoms are prominent early features in male MSA patients. Lower urinary tract infections (UTIs) are a major cause of morbidity and mortality in this disorder. More than 50% of MSA patients suffer from recurrent lower UTIs and a significant number (∼25%) die of complications related to them. Urogenital symptoms in MSA are usually due to a complex mixture of central and peripheral nervous abnormalities, sometimes superimposed on previous local pathological conditions such as benign prostatic hyperplasia and perineal laxity. There have been instances were MSA‐related urological symptoms were confused with symptoms of benign prostatic hyperplasia, leading to unnecessary urological surgery. In this review, we present the phenotypic range and therapeutic approaches for common storage and voiding urological symptoms and ED, in patients with MSA. Neurourol. Urodynam. © 2007 Wiley‐Liss, Inc.