Micturitional disturbance in neuro-Behcet's syndrome

Background: Micturitional disturbance is known to occur in neuro-Behcet's s yndrome (NBS). However, its pathophysiology is uncertain and few data are a vailable concerning urodynamic findings. We describe our findings on mictur itional histories and urodynamic studies in patients with NBS. Methods: A h istory of urinary symptoms was obtained from nine patients with NBS [seven male, two female, aged 26 to 54 years; mean, 41 years]. Neurological and CT /MRI findings indicated that their lesions were located mainly in the cereb ral cortex, basal ganglia, cerebellum, brainstem and the spinal cord. Sympt omatic patients underwent urodynamic studies, including measurement of post -micturition residuals, urethral pressure profilometry and EMG cystometry. Results: Six of the nine patients (67%) had urinary symptoms that included diurnal urinary frequency in five, sensation of urgency in five, urge urina ry incontinence in five, voiding difficulty in five and nocturnal urinary f requency in four. None had urinary retention. Urodynamic studies performed in six patients showed post-micturition residuals in five (50-180 ml), incr eased maximum urethral closure pressure in two, decrease in four and increa se in one of bladder capacities, detrusor hyperreflexia in five, decreased bladder sensation in one, brisk bulbocavernosus reflex in four, detrusor-sp hincter dyssynergia in two and neurogenic sphincter EMG in one. Conclusion: Our results indicate that micturitional disturbance is not rare in patient s with NBS. Supranuclear pelvic nerve dysfunction seems to be mainly respon sible for the disturbance. (C) 2000 Elsevier Science B.V. All rights reserv ed.