ABSTRACT
This chapter reviews the concepts of urinary dysfunction in Multiple system atrophy, with particular reference to urinary symptoms, (video-) urodynamic assessment and sphincter electromyography, and patient management. Multiple system atrophy is an uncommon but well-recognized disease entity that both neurologists and urologists may encounter. Patients may present with urinary incontinence, urinary retention, or a combination of incontinence and incomplete bladder emptying. It is important that other common causes of poor bladder control are excluded by a urologist or urogynecologist before the disorder is attributed to the neurological condition. It is well known that cerebral diseases can lead to a loss of the brain’s inhibitory influence on the spino-bulbo-spinal micturition reflex. Since incomplete bladder emptying in patients with Multiple system atrophy is due mostly to bladder underactivity, drugs acting on outflow obstruction are unlikely to benefit all patients.
