MICTURITIONAL DISTURBANCE IN MYOTONIC-DYSTROPHY

Micturitional disturbance has attracted little attention in myotonic d ystrophy, but detailed micturitional histories revealed that two out o f six patients (33%) had micturitional symptoms. One had difficulty ur inating and the other had urinary frequency, urgency and stress incont inence. Urodynamic studies were performed in all patients and the resu lts were as follows: Two had low maximum urethral closure pressure, tw o had large and three had small bladder capacities, one had detrusor h yperreflexia and one had atonic cystometrogram. Urethral sphincter ele ctromyography revealed a decreased bulbocavernosus reflex in one, and an absent anal reflex in two. Motor unit analysis of external sphincte r was performed with one patient and showed polyphasic potentials. Dys trophic changes of the lower urinary tract muscles, as well as supranu clear type of pelvic nerve dysfunction, could cause micturitional dist urbance in patients with myotonic dystrophy.